HEARTLAND HEARING PROFESSIONALS PLLC NPI 1922542919

Audiologist (Assistive Technology Practitioner) in West Fargo, ND

NPI 1922542919 Organization Audiologist Assistive Technology Practitioner

About HEARTLAND HEARING PROFESSIONALS PLLC

Heartland Hearing Professionals Pllc is a provider established in West Fargo, North Dakota specializing in audiologist (assistive technology practitioner) . The NPI number of Heartland Hearing Professionals Pllc is 1922542919 and was assigned on December 2016. The practitioner's primary taxonomy code is 231HA2400X with license number 989 (ND). The provider is registered as an organization and their NPI record was last updated 5 years ago. Heartland Hearing Professionals Pllc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Rose Brakke Aud (Audiologist)

NPI

1922542919

Provider NameHEARTLAND HEARING PROFESSIONALS PLLC
Provider Location Address3139 BLUE STEM DR STE 108 WEST FARGO, ND 58078
Provider Mailing Address3139 BLUE STEM DR STE 108 WEST FARGO, ND 58078
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date12-08-2016
Last Update Date12-28-2016


Primary Taxonomy

Taxonomy Code231HA2400X
ClassificationAudiologist
TypeSpeech, Language and Hearing Service Providers
SpecializationAssistive Technology Practitioner
License No.989
License StateND

Business Address

HEARTLAND HEARING PROFESSIONALS PLLC
3139 BLUE STEM DR STE 108
WEST FARGO, ND
ZIP 58078
Phone: (701) 639-4595

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Mailing Address

HEARTLAND HEARING PROFESSIONALS PLLC
3139 BLUE STEM DR STE 108
WEST FARGO, ND
ZIP 58078
Phone: (701) 639-4595



Authorized Official

Authorized Official Name ROSE BRAKKE AUD
Authorized Official TitleAUDIOLOGIST
Authorized Official Phone(701) 430-1017

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
1023297348MEDICAID (05)MN
1458557MEDICAID (05)ND

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023297348 ROSE I BRAKKE AUD
Individual
Audiologist3139 BLUE STEM DR STE 108
WEST FARGO, ND 58078
(701) 639-4595

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.