Individual provider Active NPI

Jamie E Monzingo, AUD

  • Audiologist
  • Columbia, SC
National Provider Identifier
1982040572
Registry record updated Jun 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4084 Issued in SC
Practice address
200 Arbor Lake Dr Ste 120
Columbia, SC 29223-4516
Phone
(803) 457-8120
Fax
(803) 457-8129
NPI assigned
May 22, 2013
Last updated
Jun 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4084 SC Primary

Addresses

Primary practice location

200 Arbor Lake Dr Ste 120
Columbia, SC 29223-4516

Mailing address

2295 Henry Tecklenburg Dr
Charleston, SC 29414-7801
Phone (843) 766-7103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180118000202 SC Practitioner - Qualified Audiologist 6002058815 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
4084SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston ENT Associates, LLC CurrentSince Nov 1, 2020 Accepting new patients
Charleston ENT Associates, LLC CurrentSince Nov 1, 2020 Accepting new patients
Northland Hearing Centers, Inc. Past Accepting new patients
Northland Hearing Centers, Inc. Audiologist PastSince Nov 1, 2010 Accepting new patients

Locations

1849 Savage Rd
Charleston, SC 29407
Phone (843) 576-2600

2295 Henry Tecklenburg Dr
Charleston, SC 29414

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1982040572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2295 HENRY TECKLENBURG DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-766-7103",
            "fax_number": "803-457-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 ARBOR LAKE DR STE 120",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292234516",
            "telephone_number": "803-457-8120",
            "fax_number": "803-457-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONZINGO",
        "first_name": "JAMIE",
        "middle_name": "E",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "4084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.