Organization Active NPI

Ekho Audiology LLC

  • Audiologist
  • Bend, OR
National Provider Identifier
1760250294
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
EKHO AUDIOLOGY LLC
Practice address
780 NW York Dr Ste 102
Bend, OR 97703-1054
Phone
(541) 280-7548
Fax
(541) 904-8378
NPI assigned
Dec 14, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Kelly Mankin Anderson, AUDNPI 1083234710
Title
Audiologist
Phone
(541) 280-7548

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary
Hearing and Speech Clinic/Center 261QH0700X

Addresses

Primary practice location

780 NW York Dr Ste 102
Bend, OR 97703-1054

Mailing address

780 NW York Dr Ste 102
Bend, OR 97703-1054
Phone (541) 280-7548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240108005541 OR Part B Supplier - Clinic/Group Practice 4981055571 Receives reassigned benefits from 1 practitioner
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

320 SW Century Dr
Ste 405149
Bend, OR 97702

780 NW York Dr
Ste 102
Bend, OR 97703
Phone (541) 280-7548

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1760250294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 NW YORK DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031054",
            "telephone_number": "541-280-7548",
            "fax_number": "541-904-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 NW YORK DR STE 102",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977031054",
            "telephone_number": "541-280-7548",
            "fax_number": "541-904-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EKHO AUDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-14",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MANKIN",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "541-280-7548",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.