Individual provider Active NPI

Sarah Mullervy, AUD

  • Audiologist
  • Grand Junction, CO
National Provider Identifier
1770246142
Registry record updated Feb 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
0001076 Issued in CO
Practice address
2139 N 12TH St Ste 4
Grand Junction, CO 81501-2910
Phone
(970) 549-4660
NPI assigned
Oct 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 0001076 CO Primary

Addresses

Primary practice location

2139 N 12TH St Ste 4
Grand Junction, CO 81501-2910

Mailing address

242 N Plum St
Fruita, CO 81521-2130

Other identifiers 1

IdentifierTypeStateIssuer
1Z5982OtherCOMEDICARE-NORIDIAN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@wchearingclinic.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220202000201 CO Practitioner - Qualified Audiologist 1254724982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001076COMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Colorado Hearing Clinic PLLC Audiologist CurrentSince Oct 27, 2021 Accepting new patients

Locations

2139 N 12th St
Ste 4
Grand Junction, CO 81501
Phone (970) 257-7116

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1634774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643760000000",
    "number": "1770246142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N PLUM ST",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815212130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2139 N 12TH ST STE 4",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815012910",
            "telephone_number": "970-549-4660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLERVY",
        "first_name": "SARAH",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-21",
        "last_updated": "2022-02-02",
        "certification_date": "2022-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "0001076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-NORIDIAN",
            "identifier": "1Z5982",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@wchearingclinic.com",
            "affiliation": "N",
            "address_1": "2139 N 12th St Ste 4",
            "city": "Grand Junction",
            "state": "CO",
            "country_code": "US",
            "postal_code": "815012910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; 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.