Active NPI
Angi Martinprudent, AUDIOLOGIST
- Audiologist
- Galesburg, IL
National Provider Identifier
1932466836
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147001084
- Practice address
- 975 N Henderson St
Suite 3
Galesburg, IL 61401-2577 - Phone
- (309) 342-0458
- Fax
- (309) 342-0458
- NPI assigned
- Apr 16, 2012
- Last updated
- Apr 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 147001084 | IL | Primary |
Addresses
Primary practice location
975 N Henderson St
Suite 3
Galesburg, IL 61401-2577
Mailing address
975 N Henderson St
Suite 3
Galesburg, IL 61401-2577
Phone (309) 342-0458
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
| License | State | Type | Specialty |
|---|---|---|---|
| 147001084 | IL | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334534400000",
"number": "1932466836",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "975 N HENDERSON ST",
"address_2": "SUITE 3",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614012577",
"telephone_number": "309-342-0458",
"fax_number": "309-342-0458"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "975 N HENDERSON ST",
"address_2": "SUITE 3",
"city": "GALESBURG",
"state": "IL",
"postal_code": "614012577",
"telephone_number": "309-342-0458",
"fax_number": "309-342-0458"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINPRUDENT",
"first_name": "ANGI",
"credential": "AUDIOLOGIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-16",
"last_updated": "2012-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147001084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Galesburg, IL
- Sharon L Marguglio, APRN, CNP
- Marigold Hco LLC (Marigold Rehabilitation & Health Care Center)
- Marigold Hco LLC (Marigold Rehabilitation & Health Care Center)
- Marigold Rehabilitation & Health Care Center LLC
- Diana Martin, SLP
- Carolyn Marty, LSW
- Sterlon A. Matheny, APRN, CRNA
- Jennette K Mathre, RN
- Alisa Lynn May, L.P.N.
- Allison Claire McCafferty, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.