Advanced Hearing Care PC | NPI 1811070980

Key facts

NPI: 1811070980
Entity type: Organization (NPI type 2)
Primary specialty: Assistive Technology Supplier Audiologist 231HA2500X
License: 190 (OK)
Legal business name: ADVANCED HEARING CARE PC
Practice address: 4100 SE Adams Rd
Suite C106
Bartlesville, OK 74006-8437
Phone: (918) 333-9992
Fax: (918) 333-9996
NPI assigned: Oct 23, 2006
Organization subpart: No

Authorized official

Name: Dr. Stephanie Rachel Moore, AUD
Title: Audiologist Owner
Phone: (918) 333-9992

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Assistive Technology Supplier Audiologist Group: 193400000X SINGLE SPECIALTY GROUP	231HA2500X	190	OK	Yes

Addresses

Primary practice location

4100 SE Adams Rd
Suite C106
Bartlesville, OK 74006-8437

Mailing address

4100 SE Adams Rd
Suite C106
Bartlesville, OK 74006-8437
Phone (918) 333-9992

Other identifiers

Identifier	Type	State	Issuer
200095630A	Medicaid	OK

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2020.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811070980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SE ADAMS RD",
            "address_2": "SUITE C106",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740068437",
            "telephone_number": "918-333-9992",
            "fax_number": "918-333-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 SE ADAMS RD",
            "address_2": "SUITE C106",
            "city": "BARTLESVILLE",
            "state": "OK",
            "postal_code": "740068437",
            "telephone_number": "918-333-9992",
            "fax_number": "918-333-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED HEARING CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "RACHEL",
        "authorized_official_title_or_position": "AUDIOLOGIST OWNER",
        "authorized_official_telephone_number": "918-333-9992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231HA2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "OK",
            "license": "190",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200095630A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlesville, OK

All providers in Bartlesville, OK · Assistive Technology Supplier Audiologist in Oklahoma

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.