Active NPI
Khayman Stauffer
- Hearing Instrument Specialist
- Boise, ID
National Provider Identifier
1992332688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HA-4058
- Practice address
- 4696 W Overland Rd Ste 216
Boise, ID 83705-2864 - Phone
- (208) 713-5004
- Fax
- (208) 327-9828
- NPI assigned
- Mar 24, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HA-4058 | ID | Primary |
Addresses
Primary practice location
4696 W Overland Rd Ste 216
Boise, ID 83705-2864
Mailing address
9718 W Touchstone Dr
Boise, ID 83709-6973
Phone (208) 509-5836
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
| License | State | Type | Specialty |
|---|---|---|---|
| HA-4058 | ID | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585008000000",
"number": "1992332688",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9718 W TOUCHSTONE DR",
"city": "BOISE",
"state": "ID",
"postal_code": "837096973",
"telephone_number": "208-509-5836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4696 W OVERLAND RD STE 216",
"city": "BOISE",
"state": "ID",
"postal_code": "837052864",
"telephone_number": "208-713-5004",
"fax_number": "208-327-9828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAUFFER",
"first_name": "KHAYMAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-24",
"last_updated": "2020-03-24",
"certification_date": "2020-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "ID",
"license": "HA-4058",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.