NPIMap

Individual provider Active NPI

Todd Ellifritz, HIS/BS

  • Hearing Instrument Specialist
  • Keyser, WV
National Provider Identifier
1851069223
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
1026 Issued in WV
Practice address
309 Polish Pines Loop
Keyser, WV 26726-6702
Phone
(304) 413-0184
Fax
(304) 413-0185
NPI assigned
Sep 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 237700000X 1026 WV Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X 1026 WV

Addresses

Primary practice location

309 Polish Pines Loop
Keyser, WV 26726-6702

Mailing address

309 Polish Pines Loop
Keyser, WV 26726-6702
Phone (304) 413-0184

Other practice location 1

608 N Main St
Moorefield, WV 26836-1081
Phone (304) 538-3464

Other practice location 2

305 Virginia Ave
Petersburg, WV 26847-1717
Phone (304) 257-5205

Other practice location 3

1425 Earl L Core Rd
Morgantown, WV 26505-5885
Phone (304) 413-0184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
1026WVMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Heritage Hearing Aid Centers, LLC Past Accepting new patients
Hearing Central Past Accepting new patients
Heritage Hearing Aid Centers, LLC. Past Accepting new patients

Organizations & group practices 3

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": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1851069223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 POLISH PINES LOOP",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267266702",
            "telephone_number": "304-413-0184",
            "fax_number": "304-413-0185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 POLISH PINES LOOP",
            "city": "KEYSER",
            "state": "WV",
            "postal_code": "267266702",
            "telephone_number": "304-413-0184",
            "fax_number": "304-413-0185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "608 N Main St",
            "address_purpose": "LOCATION",
            "city": "Moorefield",
            "state": "WV",
            "postal_code": "268361081",
            "country_code": "US",
            "telephone_number": "304-538-3464",
            "fax_number": "304-413-0185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "305 Virginia Ave",
            "address_purpose": "LOCATION",
            "city": "Petersburg",
            "state": "WV",
            "postal_code": "268471717",
            "country_code": "US",
            "telephone_number": "304-257-5205",
            "fax_number": "304-413-0185",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1425 Earl L Core Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265055885",
            "country_code": "US",
            "telephone_number": "304-413-0184",
            "fax_number": "304-413-0185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIFRITZ",
        "first_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "HIS/BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2024-08-30",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": "WV",
            "license": "1026",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "WV",
            "license": "1026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keyser, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.