Individual provider Active NPI

Adrienne Am Thomalla, AUDIOLOGIST

  • Audiologist
  • Kearney, NE
National Provider Identifier
1922098656
Registry record updated Oct 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
228 Issued in NE
Practice address
615 West 39TH Street
Kearney, NE 68845-8001
Phone
(308) 865-2277
Fax
(308) 865-2523
NPI assigned
Oct 25, 2005
Last updated
Oct 7, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 228 NE Primary
Audiologist-Hearing Aid Fitter 237600000X 709 NE

Addresses

Primary practice location

615 West 39TH Street
Kearney, NE 68845-8001

Mailing address

615 West 39TH Street
Kearney, NE 68845-8001
Phone (308) 865-2277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080913000067 NE Practitioner - Qualified Audiologist 8921174053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Physicians of Kearney PCGroup PAC ID 3678551439, 9 clinicians

Practice addresses (Care Compare)

615 W 39TH St
Kearney, NE 68845-8045
Phone (308) 865-2277

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.34 of 100Reported as group
Quality
52.69
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
228NEMDFamily Medicine Physician
709NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT Physicians of Kearney, P.C. Audiologist CurrentSince Oct 1, 2008 Accepting new patients
Allergy, Asthma & Immunology Associates P.C. PastSince Oct 1, 2008 Accepting new patients

Locations

615 W 39th St
Kearney, NE 68845
Phone (308) 698-2820

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16359/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1922098656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WEST 39TH STREET",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458001",
            "telephone_number": "308-865-2277",
            "fax_number": "308-865-2523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WEST 39TH STREET",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688458001",
            "telephone_number": "308-865-2277",
            "fax_number": "308-865-2523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMALLA",
        "first_name": "ADRIENNE",
        "middle_name": "AM",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NE",
            "license": "228",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NE",
            "license": "709",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.