Organization Active NPI

Anderson Audiology Consultants, PA

  • Audiologist
  • Anderson, SC
National Provider Identifier
1780723569
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
SC2405 Issued in SC
Legal business name
ANDERSON AUDIOLOGY CONSULTANTS, PA
Practice address
101 Broadbent Way
Anderson, SC 29625
Phone
(864) 222-0059
Fax
(864) 222-9008
NPI assigned
Feb 6, 2007
Last updated
Oct 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Authorized official

Name
Alan K Smith, AU.D.NPI 1215930664
Title
Doctor of Audiology, President
Phone
(864) 222-0059

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X SC2405 SC Primary

Addresses

Primary practice location

101 Broadbent Way
Anderson, SC 29625

Mailing address

101 Broadbent Way
Anderson, SC 29625
Phone (864) 222-0059

Other identifiers 1

IdentifierTypeStateIssuer
SA0500MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060504000127 SC Part B Supplier - Clinic/Group Practice 6800806803 Receives reassigned benefits from 1 practitioner
Practice locations: Anderson, SC

National Provider Directory

National Provider Directory

Locations

101 Broadbent Way
Anderson, SC 29625
Phone (864) 222-0059

1209B N Fant St
Anderson, SC 29621
Phone (864) 222-0059

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1780723569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BROADBENT WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29625",
            "telephone_number": "864-222-0059",
            "fax_number": "864-222-9008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BROADBENT WAY",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "29625",
            "telephone_number": "864-222-0059",
            "fax_number": "864-222-9008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON AUDIOLOGY CONSULTANTS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DOCTOR OF AUDIOLOGY, PRESIDENT",
        "authorized_official_telephone_number": "864-222-0059",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "SC2405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0500",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.