Individual provider Active NPI

Kevin W Hague, M.A., CCC-A

  • Audiologist
  • Kennewick, WA
National Provider Identifier
1780698597
Registry record updated Jan 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
CD00000983 Issued in WA
Practice address
8102 W. Grandridge Blvd
Suite a
Kennewick, WA 99336
Phone
(509) 735-7461
Fax
(509) 783-8167
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X CD00000983 WA Primary
Audiologist-Hearing Aid Fitter 237600000X CD00000983 WA

Addresses

Primary practice location

8102 W. Grandridge Blvd
Suite a
Kennewick, WA 99336

Mailing address

8102 W. Grandridge Blvd
Suite a
Kennewick, WA 99336
Phone (509) 735-7461

Other identifiers 1

IdentifierTypeStateIssuer
8338394MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070531000601 ID Practitioner - Qualified Audiologist 9830297712 Reassigns benefits to 1 organization
I20100326000998 WA Practitioner - Qualified Audiologist 9830297712 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CD00000983WAMDAudiologist

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, 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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1780698597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8102 W. GRANDRIDGE BLVD",
            "address_2": "SUITE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-735-7461",
            "fax_number": "509-783-8167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8102 W. GRANDRIDGE BLVD",
            "address_2": "SUITE A",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "99336",
            "telephone_number": "509-735-7461",
            "fax_number": "509-783-8167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGUE",
        "first_name": "KEVIN",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "M.A., CCC-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "CD00000983",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WA",
            "license": "CD00000983",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8338394",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.