Individual provider Active NPI

Kathleen S. Liston, MA, CCC-A

  • Audiologist
  • Deerfield, IL
National Provider Identifier
1942359153
Registry record updated May 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.00793 Issued in OH
Practice address
775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342
Phone
(847) 267-8200
Fax
(847) 267-9440
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2008

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.00793 OH Primary

Addresses

Primary practice location

775 Waukegan Rd
Suite 200
Deerfield, IL 60015-4342

Mailing address

5600 Hichitee CT
Liberty TWP, OH 45011-1282
Phone (847) 267-8200

Other identifiers 3

IdentifierTypeStateIssuer
000000543958OtherOHANTHEM BCBS
2710794MedicaidOH
000000513135OtherOHANTHEM BCBS

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A.00793OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Primesource Healthcare Systems, Inc. Audiologist Past Accepting new patients
Primesource Healthcare Systems, Inc. Past Accepting new patients
American Hearing Solutions, LLC PastSince Aug 19, 2004 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210291200000",
    "number": "1942359153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 HICHITEE CT",
            "city": "LIBERTY TWP",
            "state": "OH",
            "postal_code": "450111282",
            "telephone_number": "847-267-8200",
            "fax_number": "847-267-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 WAUKEGAN RD",
            "address_2": "SUITE 200",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154342",
            "telephone_number": "847-267-8200",
            "fax_number": "847-267-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTON",
        "first_name": "KATHLEEN",
        "middle_name": "S.",
        "credential": "MA, CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.00793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000543958",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2710794",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000513135",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.