Portage Valley Hearing, LLC

Primary specialty

Hearing and Speech Clinic/CenterTaxonomy code 261QH0700X

Legal business name

PORTAGE VALLEY HEARING, LLC

Practice address

133 E Front St
Pemberville, OH 43450-7032

Phone

(419) 287-2201

Fax

(419) 287-2202

NPI assigned

Apr 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca Leann Krukemyer, AU.D.NPI 1780656082

Title

Owner/Audiologist

Phone

(419) 287-2201

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rebecca L. Krukemyer, AU.D.

  • Audiologist
  • Pemberville, OH
  • NPI 1780656082
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1881868784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 E. FRONT STREET",
            "address_2": "P. O. BOX 687",
            "city": "PEMBERVILLE",
            "state": "OH",
            "postal_code": "43450",
            "telephone_number": "419-287-2201",
            "fax_number": "419-287-2202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 E FRONT ST",
            "city": "PEMBERVILLE",
            "state": "OH",
            "postal_code": "434507032",
            "telephone_number": "419-287-2201",
            "fax_number": "419-287-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTAGE VALLEY HEARING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-22",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "KRUKEMYER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LEANN",
        "authorized_official_title_or_position": "OWNER/AUDIOLOGIST",
        "authorized_official_telephone_number": "419-287-2201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kimberly Reichert
• Amy Reimer
• Sara June Riley, COTA/L

• All providers in Pemberville, OH
• Hearing and Speech Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.