Upstate Hearing and Balance LLC

Primary specialty

AudiologistTaxonomy code 231H00000X

Legal business name

UPSTATE HEARING AND BALANCE LLC

Practice address

25 Woods Lake Rd Ste 401
Greenville, SC 29607-2763

Phone

(803) 528-7069

NPI assigned

Oct 28, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kathryn Miles Jackson, AUD

Title

Owner, Audiologist

Phone

(803) 528-7069

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathryn Miles Jackson, AUD

  • Audiologist
  • Greenville, SC
  • NPI 1447632922
  Medicare reassignment Care Compare group NPD
• Brooke E Jennings, AUD

  • Audiologist
  • Greenville, SC
  • NPI 1871333096
  Medicare reassignment Care Compare group NPD
• Kim Thien Nguyen Ho, AU.D.

  • Audiologist
  • Rock Hill, SC
  • NPI 1356639025
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635379200000",
    "number": "1730843442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CARRONBRIDGE WAY",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296096818",
            "telephone_number": "803-528-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WOODS LAKE RD STE 401",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296072763",
            "telephone_number": "803-528-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTATE HEARING AND BALANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-28",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A",
        "authorized_official_last_name": "MILES JACKSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "OWNER, AUDIOLOGIST",
        "authorized_official_telephone_number": "803-528-7069",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Greenville, SC
• Providers in Greenville, SC by specialty
• Audiologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.