Individual provider Active NPI

Nicole Zander Raven, AUD

  • Audiologist-Hearing Aid Fitter
  • Flemington, NJ
National Provider Identifier
1790922797
Registry record updated Feb 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
41YA00096400 Issued in NJ
Practice address
6 Sand Hill Rd Ste 302
Flemington, NJ 08822
Phone
(908) 788-9131
Fax
(908) 788-0945
NPI assigned
Jan 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 41YA00096400 NJ Primary

Addresses

Primary practice location

6 Sand Hill Rd Ste 302
Flemington, NJ 08822

Mailing address

1843 S Broad St
Philadelphia, PA 19148-2115
Phone (215) 629-1353

Other practice location 1

1843 S Broad St
Philadelphia, PA 19148-2115
Phone (215) 629-1353

Other names 1

  • Miss Nicole Bush Raven Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240402003682 TX Practitioner - Qualified Audiologist 1557419835 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benke Ear Nose and Throat ClinicGroup PAC ID 9739253741, 2 clinicians

Practice addresses (Care Compare)

1317 Glenwood Dr
Cleburne, TX 76033-4654
Phone (817) 641-3750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benke Ear Nose and Throat Clinic Audiologist-Hearing Aid Fitter CurrentSince Apr 1, 2024 Accepting new patients
Associates in Audiology of Chester County Past Accepting new patients

Locations

1317 Glenwood Dr
Cleburne, TX 76033
Phone (817) 641-3750

Organizations & group practices 2

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": "1231804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1790922797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1843 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191482115",
            "telephone_number": "215-629-1353",
            "fax_number": "215-629-1395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SAND HILL RD STE 302",
            "city": "FLEMINGTON",
            "state": "NJ",
            "postal_code": "08822",
            "telephone_number": "908-788-9131",
            "fax_number": "908-788-0945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1843 S Broad St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191482115",
            "country_code": "US",
            "telephone_number": "215-629-1353",
            "fax_number": "215-629-1395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAVEN",
        "first_name": "NICOLE",
        "middle_name": "ZANDER",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-13",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "41YA00096400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "RAVEN",
            "middle_name": "BUSH",
            "prefix": "MISS",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flemington, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.