Individual provider Active NPI

Amy Christine Badstubner, AU.D.

  • Audiologist
  • Southlake, TX
National Provider Identifier
1760822399
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80477 Issued in TX
Practice address
578 N Kimball Ave
Suite 140
Southlake, TX 76092-6883
Phone
(817) 778-4934
Fax
(817) 380-3256
NPI assigned
Jun 27, 2013
Last updated
Oct 21, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80477 TX Primary
Audiologist-Hearing Aid Fitter 237600000X 80477 TX

Addresses

Primary practice location

578 N Kimball Ave
Suite 140
Southlake, TX 76092-6883

Mailing address

578 N Kimball Ave
Suite 140
Southlake, TX 76092-6883
Phone (817) 421-3277

Other identifiers 2

IdentifierTypeStateIssuer
362902ZH8SOtherTXMEDICARE
362901OtherTXMEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
80477TXMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Audiology Audiologist CurrentSince Mar 26, 2023 Accepting new patients

Locations

578 N Kimball Ave
Ste 140
Southlake, TX 76092
Phone (817) 421-3277

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1760822399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 N KIMBALL AVE",
            "address_2": "SUITE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926883",
            "telephone_number": "817-421-3277",
            "fax_number": "817-380-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 N KIMBALL AVE",
            "address_2": "SUITE 140",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926883",
            "telephone_number": "817-778-4934",
            "fax_number": "817-380-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADSTUBNER",
        "first_name": "AMY",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80477",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "80477",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "362902ZH8S",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "362901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.