Individual provider Active NPI

Alexandra Marie Jackson, AU.D.

  • Audiologist
  • Altoona, PA
National Provider Identifier
1821829847
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AT006985 Issued in PA
Practice address
613 Valley View Blvd
Altoona, PA 16602-6411
Phone
(814) 941-7770
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AT006985 PA Primary

Addresses

Primary practice location

613 Valley View Blvd
Altoona, PA 16602-6411

Mailing address

1001 7TH Ave
Duncansville, PA 16635-1338
Phone (814) 932-9079

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917002690 PA Practitioner - Qualified Audiologist 4082155122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AT006985PAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Karen R Lemme Audiologist CurrentSince Dec 15, 2024 Accepting new patients

Locations

613 Valley View Blvd
Altoona, PA 16602
Phone (814) 889-0310

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, 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": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1821829847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 7TH AVE",
            "city": "DUNCANSVILLE",
            "state": "PA",
            "postal_code": "166351338",
            "telephone_number": "814-932-9079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 VALLEY VIEW BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166026411",
            "telephone_number": "814-941-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": "AT006985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.