Individual provider Active NPI

Greta Eikenberry, AU.D.

  • Audiologist
  • Saint Louis, MO
National Provider Identifier
1821439654
Registry record updated May 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
30817 Issued in OR
Practice address
1 Childrens PL
Saint Louis, MO 63110-1002
Phone
(314) 454-2532
Fax
(314) 454-4097
NPI assigned
Jul 9, 2013
Last updated
May 6, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 30817 OR Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

1 Childrens PL
Saint Louis, MO 63110-1002

Mailing address

2801 N Gantenbein Ave
St. S3231
Portland, OR 97227-1623
Phone (503) 413-2128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20161221000878 OR Practitioner - Qualified Audiologist 5193006617 Reassigns benefits to 1 organization
I20220331000213 AK Practitioner - Qualified Audiologist 5193006617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northland Audiology and Hearing Serv IncGroup PAC ID 1456429646, 5 clinicians

Practice addresses (Care Compare)

8800 Glacier Hwy
Suite 116
Juneau, AK 99801-8079
Phone (907) 789-6780

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30817ORMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 1, 2016 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Sep 1, 2016 Accepting new patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients

Locations

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

2801 N Gantenbein Ave
#S3231
Portland, OR 97227

2801 N Gantenbein Ave
Ste 2225
Portland, OR 97227
Phone (503) 413-4505

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430870400000",
    "number": "1821439654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N GANTENBEIN AVE",
            "address_2": "ST. S3231",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972271623",
            "telephone_number": "503-413-2128",
            "fax_number": "503-413-3959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2532",
            "fax_number": "314-454-4097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIKENBERRY",
        "first_name": "GRETA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2015-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OR",
            "license": "30817",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2015; 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.