Adrienne Am Thomalla, AUDIOLOGIST
Individual provider Active NPI Audiologist · Kearney, NE
NPI 1922098656 · NPPES record last updated Oct 7, 2008
Key facts
- NPI
- 1922098656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 228 (NE)
- Practice address
- 615 West 39TH Street
Kearney, NE 68845-8001 - Phone
- (308) 865-2277
- Fax
- (308) 865-2523
- NPI assigned
- Oct 25, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Qualified Audiologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- ENT Physicians of Kearney PC
Practice addresses (Care Compare)
615 W 39TH St
Kearney, NE 68845-8045
Phone (308) 865-2277
Hospital & facility affiliations
- Phelps Memorial Health Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 76.34 of 100
- Quality
- 52.69
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080913000067 | NE | Practitioner - Qualified Audiologist | 8921174053 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 228 | NE | MD | Physical Therapist |
| 709 | NE | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| ENT Physicians of Kearney, P.C. | Audiologist | Current |
Accepting new patients |
| Allergy, Asthma & Immunology Associates P.C. | Past |
Accepting new patients |
Locations
615 W 39th St
Kearney, NE 68845
Phone (308) 698-2820
Interoperability endpoints
- https://api.platform.athenahealth.com/16359/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 228 | NE | Yes |
| 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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47077661900 | Medicaid | NE | |
| 47077661964 | Medicaid | NE |
Other providers in Kearney, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.