Eastern Idaho Audiology, LLC

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

AUD1214 Issued in ID

Legal business name

EASTERN IDAHO AUDIOLOGY, LLC

Practice address

4155 Yellowstone Ave
Pine Ridge Mall
Chubbuck, ID 83202-2345

Phone

(208) 238-0020

Fax

(208) 238-0021

NPI assigned

Jan 5, 2010

Organization subpart

Yes

Parent organization

EASTERN IDAHO AUDIOLOGYAs reported in NPPES

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

Authorized official

Name

Dr. Kelley J Olenick, AU.D.

Title

Owner/Audiologist

Phone

(208) 238-0020

Specialties & licenses 1

Addresses

Other names 1

• Pocatello Hearing Zone Doing business as

Part of

Eastern Idaho Audiology LLC

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1972833481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7808 W POCATELLO CREEK RD",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832019058",
            "telephone_number": "208-235-1544",
            "fax_number": "208-238-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 YELLOWSTONE AVE",
            "address_2": "PINE RIDGE MALL",
            "city": "CHUBBUCK",
            "state": "ID",
            "postal_code": "832022345",
            "telephone_number": "208-238-0020",
            "fax_number": "208-238-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN IDAHO AUDIOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN IDAHO AUDIOLOGY",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "OLENICK",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/AUDIOLOGIST",
        "authorized_official_telephone_number": "208-238-0020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "ID",
            "license": "AUD1214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocatello Hearing Zone",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Dallon Draper, PARAPROFESSIONAL
• Kiara Draven, PARAPROFESSIONAL
• Landon Duval, LPC
• Josephine Elaine Dye, RD
• Robb Dye, LCSW
• Elite Care Chiropractic
• Cassidy Ellsworth, MS
• Emeritus Corporation
• Joyce E Engel, LPC
• Courtney Escalona, RDN

• Audiologist-Hearing Aid Fitter in Chubbuck, ID
• Providers in Chubbuck, ID by specialty
• Audiologist-Hearing Aid Fitter in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.