Individual provider Active NPI

Tara Janae Minnix-Harmon, AU.D., CCC-A

  • Audiologist
  • Princeton, WV
National Provider Identifier
1962799338
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-0276 Issued in WV
Practice address
508 New Hope Road
Suite #19
Princeton, WV 24740-2272
Phone
(304) 487-2487
Fax
(304) 431-3367
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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-0276 WV Primary

Addresses

Primary practice location

508 New Hope Road
Suite #19
Princeton, WV 24740-2272

Mailing address

508 New Hope Road
Suite #19
Princeton, WV 24740-2272
Phone (304) 487-2487

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110930000180 WV Practitioner - Qualified Audiologist 4183896897 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Princeton Audiology Clinic IncGroup PAC ID 1052300357, 2 clinicians

Practice addresses (Care Compare)

508 New Hope Rd
Suite 19
Princeton, WV 24740-2272
Phone (304) 487-3407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Audiology Clinic, Inc., Audiologist CurrentSince Aug 1, 2011 Accepting new patients

Locations

508 New Hope Rd
Ste 19
Princeton, WV 24740
Phone (304) 487-2487

Organizations & group practices 1

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": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1962799338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE ROAD",
            "address_2": "SUITE #19",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402272",
            "telephone_number": "304-487-2487",
            "fax_number": "304-431-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE ROAD",
            "address_2": "SUITE #19",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402272",
            "telephone_number": "304-487-2487",
            "fax_number": "304-431-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINNIX-HARMON",
        "first_name": "TARA",
        "middle_name": "JANAE",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A-0276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.