Eneida Agolli, AU.D.
Individual provider Active NPI Audiologist · Greensboro, NC
NPI 1770967424 · NPPES record last updated Mar 12, 2021
Key facts
- NPI
- 1770967424
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 11304 (NC)
- Practice address
- 532 N Elam Ave
Greensboro, NC 27403-1146 - Phone
- (336) 850-4095
- Fax
- (663) 852-4097
- NPI assigned
- Jul 13, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NC, VA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160212001180 | NC | Practitioner - Qualified Audiologist | 9234433178 | Reassigns benefits to 1 organization |
| I20220218000246 | VA | Practitioner - Qualified Audiologist | 9234433178 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11304 | NC | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Hearing, Inc. | Past |
Accepting new patients | |
| The Hearing Clinic, Inc. | Audiologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 11304 | NC | Yes |
Addresses
Primary practice location
532 N Elam Ave
Greensboro, NC 27403-1146
Mailing address
750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380
Other practice location 1
328 N Fayetteville St
Asheboro, NC 27203-5592
Phone (336) 629-6574
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All providers in Greensboro, NC · Audiologist in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.