Active NPI
Patrick Coughlin, AUD
- Audiologist
- Aberdeen, SD
National Provider Identifier
1801092929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 002
- Practice address
- 2301 8TH Avenue NE, Suite 100
Aberdeen, SD 57401-3253 - Phone
- (605) 229-3688
- Fax
- (605) 225-3000
- NPI assigned
- Jun 25, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 002 | SD | Primary |
Addresses
Primary practice location
2301 8TH Avenue NE, Suite 100
Aberdeen, SD 57401-3253
Mailing address
12996 Prairiewood Dr
Aberdeen, SD 57401-8104
Phone (605) 225-1290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5830600 | Medicaid | SD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081230000081 | SD | Practitioner - Qualified Audiologist | 5799847778 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002 | SD | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590710400000",
"number": "1801092929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12996 PRAIRIEWOOD DR",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574018104",
"telephone_number": "605-225-1290",
"fax_number": "605-225-1290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2301 8TH AVENUE NE, SUITE 100",
"city": "ABERDEEN",
"state": "SD",
"postal_code": "574013253",
"telephone_number": "605-229-3688",
"fax_number": "605-225-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COUGHLIN",
"first_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-25",
"last_updated": "2020-05-29",
"certification_date": "2020-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "SD",
"license": "002",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5830600",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aberdeen, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; 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.