Individual provider Active NPI

Jordan Saavedra, AUD

  • Audiologist
  • Tyler, TX
National Provider Identifier
1831571660
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
80649 Issued in TX
Practice address
1136 E Grande Blvd
Tyler, TX 75703-3982
Phone
(903) 592-5601
Fax
(903) 595-3304
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80649 TX Primary

Addresses

Primary practice location

1136 E Grande Blvd
Tyler, TX 75703-3982

Mailing address

1136 E Grande Blvd
Tyler, TX 75703-3982
Phone (903) 592-5601

Other practice location 1

3413 Golden Rd
Tyler, TX 75701-8355
Phone (903) 592-5601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150728005338 TX Practitioner - Qualified Audiologist 0749594257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heaton Ear Nose and Throat Associates of East Texas P a CurrentSince Jun 10, 2015 Accepting new patients
Tyler Radiology Associates PA Past Accepting new patients

Locations

3413 Golden Rd
Tyler, TX 75701
Phone (903) 592-3666

1136 E Grande Blvd
Tyler, TX 75703
Phone (903) 592-3666

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": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831571660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033982",
            "telephone_number": "903-592-5601",
            "fax_number": "903-595-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E GRANDE BLVD",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757033982",
            "telephone_number": "903-592-5601",
            "fax_number": "903-595-3304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3413 Golden Rd",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757018355",
            "country_code": "US",
            "telephone_number": "903-592-5601",
            "fax_number": "903-595-3304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAAVEDRA",
        "first_name": "JORDAN",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.