Individual provider Active NPI

Nicole Lynn Brandes, AU.D.

  • Audiologist
  • Athens, OH
National Provider Identifier
1932361797
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-01095 Issued in OH
Practice address
174 W Grover Center
Athens, OH 45701
Phone
(740) 593-1413
NPI assigned
Jul 1, 2008
Last updated
Oct 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-01095 OH Primary

Addresses

Primary practice location

174 W Grover Center
Athens, OH 45701

Mailing address

174 W Grover Center
Athens, OH 45701
Phone (740) 593-1413

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110526000086 OH Practitioner - Qualified Audiologist 0749466829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohio UniversityGroup PAC ID 6406764117, 6 clinicians

Practice addresses (Care Compare)

W 174 Grover Ctr
Athens, OH 45701-1367
Phone (740) 593-1404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A-01095OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio University CurrentSince May 1, 2011 Accepting new patients
Ohio University Audiologist CurrentSince May 1, 2011 Accepting new patients
Mre Goc Inc CurrentSince Dec 22, 2021 Accepting new patients

Locations

174 Grover Ctr
Athens, OH 45701
Phone (740) 593-1404

499 Richland Ave
Athens, OH 45701
Phone (740) 594-4476

Organizations & group practices 3

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": "1214870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1932361797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 W GROVER CENTER",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-593-1413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 W GROVER CENTER",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "45701",
            "telephone_number": "740-593-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDES",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-01",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-01095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.