Therese Kistenfeger, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

147.001388 Issued in IL

Practice address

101 W McKinley Ave
Decatur, IL 62526-3286

Phone

(217) 876-3682

Fax

(217) 879-3345

NPI assigned

May 27, 2014

Last updated

May 27, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: theresekistenfeger@memorial.allscriptsdirect.net

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.

• Memorial Health Partners

  • Family Medicine Physician
  • Springfield, IL
  • NPI 1376034744
  NPD
• Center for Sight of Central Illinois SC

  dba Central Illinois Vision Center

  • Ophthalmology Physician
  • Decatur, IL
  • NPI 1093854820
  NPD (past)

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401148800000",
    "number": "1922410851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263286",
            "telephone_number": "217-876-3682",
            "fax_number": "217-879-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MCKINLEY AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263286",
            "telephone_number": "217-876-3682",
            "fax_number": "217-879-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISTENFEGER",
        "first_name": "THERESE",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2014-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147.001388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Kingston, MD
• Courtney Dyan Kirk
• Audria R Kirkum
• Jason Kish, CRNA
• Kimberly A Kish, APN, CNP
• Suzanne Michelle Kistner-Davis, D.C.
• Shannon Dawn Klaska, BCABA
• Susan M Klein, M.D.
• Jaclyn Nicole Kleman
• James Klemens

• Audiologist in Decatur, IL
• Providers in Decatur, IL by specialty
• Audiologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.