Individual provider Active NPI

Elizabeth Thomas

  • Audiologist
  • Eden Prairie, MN
National Provider Identifier
1780076828
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
8129 Issued in MN
Practice address
7820 Terrey Pine CT
Suite 110
Eden Prairie, MN 55347-1104
Phone
(952) 594-8358
Fax
(952) 479-4639
NPI assigned
Feb 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 8129 MN
Audiologist 231H00000X 8129 MN Primary

Addresses

Primary practice location

7820 Terrey Pine CT
Suite 110
Eden Prairie, MN 55347-1104

Mailing address

7820 Terrey Pine CT Ste 110
Eden Prairie, MN 55347-1107
Phone (952) 594-8358

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622002454 MN Practitioner - Qualified Audiologist 7911218607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Wayne State University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7820 Terrey Pine CT
Suite 110
Eden Prairie, MN 55347-1107
Phone (952) 594-8358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8129MNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
BKT Hearing LLC Audiologist CurrentSince Feb 28, 2017 Accepting new patients

Locations

7820 Terrey Pine Ct
Ste 110
Eden Prairie, MN 55347
Phone (952) 594-8358

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": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1780076828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7820 TERREY PINE CT STE 110",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471107",
            "telephone_number": "952-594-8358",
            "fax_number": "952-479-4639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7820 TERREY PINE CT",
            "address_2": "SUITE 110",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471104",
            "telephone_number": "952-594-8358",
            "fax_number": "952-479-4639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MN",
            "license": "8129",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "8129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.