Individual provider Active NPI

Tracy Haidle

  • Hearing Instrument Specialist
  • East Stroudsburg, PA
National Provider Identifier
1992249072
Registry record updated Apr 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
Practice address
400 Plaza CT Ste B
East Stroudsburg, PA 18301-8261
Phone
(570) 476-6558
NPI assigned
Dec 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X PA
Hearing Instrument Specialist 237700000X Primary

Addresses

Primary practice location

400 Plaza CT Ste B
East Stroudsburg, PA 18301-8261

Mailing address

6700 Washington Ave S
Eden Prairie, MN 55344-3405
Phone (612) 351-1529

Other practice location 1

190 S River St
Plains, PA 18705-1149
Phone (570) 344-5311

Other practice location 2

1124 Meade St
Dunmore, PA 18512-3169
Phone (570) 344-5311

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

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554249600000",
    "number": "1992249072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 WASHINGTON AVE S",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443405",
            "telephone_number": "612-351-1529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 PLAZA CT STE B",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183018261",
            "telephone_number": "570-476-6558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "190 S River St",
            "address_purpose": "LOCATION",
            "city": "Plains",
            "state": "PA",
            "postal_code": "187051149",
            "country_code": "US",
            "telephone_number": "570-344-5311",
            "fax_number": "570-344-5518",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1124 Meade St",
            "address_purpose": "LOCATION",
            "city": "Dunmore",
            "state": "PA",
            "postal_code": "185123169",
            "country_code": "US",
            "telephone_number": "570-344-5311",
            "fax_number": "570-344-5518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAIDLE",
        "first_name": "TRACY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-08",
        "last_updated": "2019-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2019; 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.