Individual provider Active NPI

Eryn Lynne Staats, AUD

  • Audiologist
  • Marysville, OH
National Provider Identifier
1811977622
Registry record updated Jul 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A01488 Issued in OH
Practice address
140 Colemans Xing Ste 200
Marysville, OH 43040-7080
Phone
(937) 578-4300
Fax
(937) 578-4301
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A01488 OH Primary

Addresses

Primary practice location

140 Colemans Xing Ste 200
Marysville, OH 43040-7080

Mailing address

140 Colemans Xing Ste 200
Marysville, OH 43040-7080
Phone (937) 578-4300

Other identifiers 1

IdentifierTypeStateIssuer
0094740MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051201001050 OH Practitioner - Qualified Audiologist 7012937279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

140 Colemans Xing
Suite 200
Marysville, OH 43040-7080
Phone (937) 578-4300

Merit-based Incentive Payment System (MIPS)

Final score
83.33 of 100Reported as group
Quality
68.93
Promoting interoperability
100
Improvement activities
40
Cost
75.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A01488OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Union County Physician Corporation CurrentSince May 1, 2021 Accepting new patients
Union County Physician Corporation CurrentSince May 1, 2021 Accepting new patients

Locations

140 Colemans Crossing Blvd
Ste 200
Marysville, OH 43040
Phone (937) 578-2207

388 Damascus Rd
Marysville, OH 43040
Phone (937) 578-2626

1958 E US Highway 36
Ste D
Urbana, OH 43078
Phone (937) 578-2626

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625702400000",
    "number": "1811977622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING STE 200",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407080",
            "telephone_number": "937-578-4300",
            "fax_number": "937-578-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 COLEMANS XING STE 200",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430407080",
            "telephone_number": "937-578-4300",
            "fax_number": "937-578-4301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAATS",
        "first_name": "ERYN",
        "middle_name": "LYNNE",
        "name_prefix": "Mrs.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2021-07-08",
        "certification_date": "2021-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A01488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0094740",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2021; 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.