Individual provider Active NPI

Rebecca Ann Dewitt, AU.D.

  • Audiologist
  • Centennial, CO
National Provider Identifier
1780067181
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
760 Issued in CO
Practice address
9137 E Mineral Cir Ste 260
Centennial, CO 80112-3423
Phone
(720) 476-7132
Fax
(720) 476-7167
NPI assigned
Jul 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 760 CO Primary

Addresses

Primary practice location

9137 E Mineral Cir Ste 260
Centennial, CO 80112-3423

Mailing address

9137 E Mineral Cir Ste 260
Centennial, CO 80112-3423
Phone (720) 476-7132

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150807015393 CO Practitioner - Qualified Audiologist 4385958024 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Modern Audiology Centennial LLCGroup PAC ID 3870826647, 3 clinicians

Practice addresses (Care Compare)

9137 E Mineral Cir
Suite 260
Centennial, CO 80112-3423
Phone (720) 476-7132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
760COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Audiology Centennial LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

9137 E Mineral Cir
Ste 260
Centennial, CO 80112
Phone (303) 708-8698

9137 E Mineral Cir
Ste 360
Centennial, CO 80112
Phone (720) 670-9046

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": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1780067181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9137 E MINERAL CIR STE 260",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123423",
            "telephone_number": "720-476-7132",
            "fax_number": "720-476-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9137 E MINERAL CIR STE 260",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801123423",
            "telephone_number": "720-476-7132",
            "fax_number": "720-476-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centennial, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.