Individual provider Active NPI

Kurt E Kalies, AU.D.

  • Audiologist
  • Shawnee, OK
National Provider Identifier
1902898000
Registry record updated Mar 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
139 Issued in OK
Practice address
3954 N. Kickapoo Ave
Shawnee, OK 74804
Phone
(405) 273-6203
NPI assigned
Aug 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 139 OK Primary

Addresses

Primary practice location

3954 N. Kickapoo Ave
Shawnee, OK 74804

Mailing address

3954 N. Kickapoo Ave
Shawnee, OK 74804
Phone (405) 273-6203

Other identifiers 1

IdentifierTypeStateIssuer
100659350AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120105000160 OK Practitioner - Qualified Audiologist 7719153212 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
139OKMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearuss LLC Audiologist CurrentSince Jul 1, 2024 Accepting new patients

Locations

3954 N Kickapoo Ave
Ste 5
Shawnee, OK 74804
Phone (405) 273-6203

3954 N Kickapoo Ave
Shawnee, OK 74804
Phone (405) 273-6203

Organizations & group practices 1

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": "1124150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458000000000",
    "number": "1902898000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3954 N. KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74804",
            "telephone_number": "405-273-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3954 N. KICKAPOO AVE",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "74804",
            "telephone_number": "405-273-6203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIES",
        "first_name": "KURT",
        "middle_name": "E",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-16",
        "last_updated": "2016-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100659350A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2016; 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.