Individual provider Active NPI

Bridget Nicole Black, AUD

  • Audiologist
  • Waco, TX
National Provider Identifier
1972193829
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81298 Issued in TX
Practice address
1411 N Valley Mills Dr Ste F
Waco, TX 76710-4453
Phone
(254) 732-1304
NPI assigned
Jan 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 81298 TX Primary

Addresses

Primary practice location

1411 N Valley Mills Dr Ste F
Waco, TX 76710-4453

Mailing address

5303 50TH St
Lubbock, TX 79414-1817
Phone (806) 799-8950

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

LicenseStateTypeSpecialty
81298TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston Hearing Aid Center, Inc. Audiologist CurrentSince Jan 31, 2021 Accepting new patients
Jack Jordan Jones Enterprises PastSince Jan 31, 2021 Accepting new patients

Locations

5303 50th St
Lubbock, TX 79414
Phone (806) 799-1484

1411 N Valley Mills Dr
Ste F
Waco, TX 76710
Phone (254) 732-1304

Organizations & group practices 2

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": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1972193829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5303 50TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794141817",
            "telephone_number": "806-799-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 N VALLEY MILLS DR STE F",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767104453",
            "telephone_number": "254-732-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BRIDGET",
        "middle_name": "NICOLE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.