Active NPI
Amy S Bannerman, MA, CCC/A
- Audiologist
- Austin, TX
National Provider Identifier
1942472188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 51250
- Practice address
- 3705 Medical Pkwy
#380
Austin, TX 78705-1019 - Phone
- (512) 380-4058
- NPI assigned
- Mar 27, 2008
- Last updated
- Mar 27, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 51250 | TX | Primary |
Addresses
Primary practice location
3705 Medical Pkwy
#380
Austin, TX 78705-1019
Mailing address
3705 Medical Pkwy
#380
Austin, TX 78705-1019
Phone (512) 380-4058
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, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51250 | TX | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206576000000",
"number": "1942472188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3705 MEDICAL PKWY",
"address_2": "#380",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051019",
"telephone_number": "512-380-4058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3705 MEDICAL PKWY",
"address_2": "#380",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051019",
"telephone_number": "512-380-4058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BANNERMAN",
"first_name": "AMY",
"middle_name": "S",
"credential": "MA, CCC/A",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-27",
"last_updated": "2008-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "51250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.