NPIMap

Organization Active NPI

Fort Hays State University

Doing business as Herndon Clinic

  • Audiologist
  • Hays, KS
National Provider Identifier
1811101454
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
FORT HAYS STATE UNIVERSITY
Doing business as
Herndon Clinic
Practice address
600 Park St
Herndon Clinic Albertson Hall 131
Hays, KS 67601-4009
Phone
(785) 628-5366
Fax
(785) 628-5271
NPI assigned
May 10, 2007
Last updated
Aug 5, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
NOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Authorized official

Name
Dr. Jayne M. Brandel, PH.D, CCC-SLP
Title
Chair
Phone
(785) 628-5366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

600 Park St
Herndon Clinic Albertson Hall 131
Hays, KS 67601-4009

Mailing address

600 Park St
Herndon Clinic Albertson Hall 131
Hays, KS 67601-4009
Phone (785) 628-5366

Other identifiers 1

IdentifierTypeStateIssuer
116209OtherKSBLUE CROSS BLUE SHIELD

Other names 1

  • Herndon Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050112001062 KS Part B Supplier - Clinic/Group Practice 8921057365 Receives reassigned benefits from 8 practitioners
2 other NPIs on this enrollment
Practice locations: Hays, KS

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Fort Hays State Univers4 organizations share this tax ID, including this one
Part of
Fort Hays State Univers

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

600 Park St
#131
Hays, KS 67601
Phone (785) 628-5366

Practitioners & affiliated clinicians

Practitioners 8

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": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407196800000",
    "number": "1811101454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PARK ST",
            "address_2": "HERNDON CLINIC ALBERTSON HALL 131",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014009",
            "telephone_number": "785-628-5366",
            "fax_number": "785-628-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PARK ST",
            "address_2": "HERNDON CLINIC ALBERTSON HALL 131",
            "city": "HAYS",
            "state": "KS",
            "postal_code": "676014009",
            "telephone_number": "785-628-5366",
            "fax_number": "785-628-5271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT HAYS STATE UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-08-05",
        "status": "A",
        "authorized_official_last_name": "BRANDEL",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "CHAIR",
        "authorized_official_telephone_number": "785-628-5366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "116209",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herndon Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hays, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.