Individual provider Active NPI

Sara Nicole O'Brien, M.A.

  • Audiologist
  • Waterloo, IA
National Provider Identifier
1891039202
Registry record updated Dec 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
00565 Issued in IA
Practice address
1753 W Ridgeway Ave
Suite 111
Waterloo, IA 50701-4544
Phone
(319) 833-5970
Fax
(319) 833-5971
NPI assigned
Nov 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 00565 IA Primary

Addresses

Primary practice location

1753 W Ridgeway Ave
Suite 111
Waterloo, IA 50701-4544

Mailing address

PO Box 2758
4150 Kimball Avenue
Waterloo, IA 50704-2758
Phone (319) 235-5390

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)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1353888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354752000000",
    "number": "1891039202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2758",
            "address_2": "4150 KIMBALL AVENUE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507042758",
            "telephone_number": "319-235-5390",
            "fax_number": "319-235-5607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 W RIDGEWAY AVE",
            "address_2": "SUITE 111",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507014544",
            "telephone_number": "319-833-5970",
            "fax_number": "319-833-5971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "SARA",
        "middle_name": "NICOLE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-26",
        "last_updated": "2012-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "00565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.