Individual provider Active NPI

Jan Storhaug, M. S., CCC-A

  • Audiologist
  • Minnetonka, MN
National Provider Identifier
1790934511
Registry record updated Sep 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
7456 Issued in MN
Practice address
11210 Wayzata Blvd Ste D
Minnetonka, MN 55305-2058
Phone
(952) 746-3011
Fax
(952) 746-3012
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 7456 MN Primary

Addresses

Primary practice location

11210 Wayzata Blvd Ste D
Minnetonka, MN 55305-2058

Mailing address

11210 Wayzata Blvd Ste D
Minnetonka, MN 55305-2058
Phone (952) 746-3011

Other identifiers 1

IdentifierTypeStateIssuer
7456OtherMNSTATE LICENSED AUDIOLOGIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7456MNMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing Inc Audiologist PastSince May 1, 2015 Accepting new patients

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": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1790934511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11210 WAYZATA BLVD STE D",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052058",
            "telephone_number": "952-746-3011",
            "fax_number": "952-746-3012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11210 WAYZATA BLVD STE D",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553052058",
            "telephone_number": "952-746-3011",
            "fax_number": "952-746-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STORHAUG",
        "first_name": "JAN",
        "name_prefix": "Mrs.",
        "credential": "M. S., CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "7456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSED AUDIOLOGIST",
            "identifier": "7456",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.