Individual provider Active NPI

Brian Keith Ergle, AU.D.

  • Audiologist
  • Pelham, AL
National Provider Identifier
1922001643
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
817A Issued in AL
Practice address
245 Cahaba Valley Pkwy
Suite 200
Pelham, AL 35124-2216
Phone
(800) 379-0309
Fax
(205) 942-5627
NPI assigned
May 27, 2005
Last updated
May 19, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 51486 TX
Audiologist 231H00000X 5652 NC
Audiologist 231H00000X A2835 MS
Audiologist 231H00000X 817A AL Primary

Addresses

Primary practice location

245 Cahaba Valley Pkwy
Suite 200
Pelham, AL 35124-2216

Mailing address

245 Cahaba Valley Pkwy
Suite 200
Pelham, AL 35124-2216
Phone (800) 379-0309

Other identifiers 4

IdentifierTypeStateIssuer
009815580MedicaidAL
631209505OtherALTRI-CARE
51007364OtherALBCBS OF ALABAMA
7401171OtherALAETNA

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

State licenses

LicenseStateTypeSpecialty
5652NCMDChiropractor
817AALMDAudiologist
A2835MSMDAudiologist
51486TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Hearing Services, Inc. Audiologist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1922001643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY",
            "address_2": "SUITE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242216",
            "telephone_number": "800-379-0309",
            "fax_number": "205-942-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CAHABA VALLEY PKWY",
            "address_2": "SUITE 200",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242216",
            "telephone_number": "800-379-0309",
            "fax_number": "205-942-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERGLE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51486",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "5652",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MS",
            "license": "A2835",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AL",
            "license": "817A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009815580",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRI-CARE",
            "identifier": "631209505",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51007364",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7401171",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.