1821375361 NPI number — DR. TODD ANDREW POWELL AU.D.

Table of content: DR. TODD ANDREW POWELL AU.D. (NPI 1821375361)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821375361 NPI number — DR. TODD ANDREW POWELL AU.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POWELL
Provider First Name:
TODD
Provider Middle Name:
ANDREW
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AU.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821375361
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7001 PROSPECT PL NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87110-4311
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-764-0036
Provider Business Mailing Address Fax Number:
505-764-0446

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7001 PROSPECT PL NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBUQUERQUE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-764-0036
Provider Business Practice Location Address Fax Number:
505-764-0446
Provider Enumeration Date:
11/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  5007 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: HSZ178 . This is a "SANTA FE INDIAN HOSPITAL MEDICARE PIN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: HSZ181 . This is a "COCHITI PUEBLO HEALTH CLINIC MEDICARE PIN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: K1576 . This is a "MEDICAID-TRIBAL AUDIOLOGY AAIHB" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 320070 . This is a "CANONCITOHC OSCAR/CERTIFICATION" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: H1232 . This is a "SANFELIPEPHC MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 82674060 . This is a "KEWA PHC MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: H1232 . This is a "COCHITI HEALTH CLINIC AND SANTA FE INDIAN HOSPITAL MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: HSZ022 . This is a "CANONCITOHC MEDICARE PIN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: HSZ164 . This is a "SANDIAPHC MEDICARE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: PHS000 . This is a "ALBUQUERQUE MEDICARE UPIN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: TR2037 . This is a "KEWA PHC MEDICARE PLAN B" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 320056 . This is a "AIHC MEDICARE UNSPECIFIED" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 320057 . This is a "SANTA FE INDIAN HOSPITAL MEDICARE O/C" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 320057 . This is a "COCHITI HEALTH CLINIC AND SANTA FE INDIAN HOSPITAL MEDICARE O/C" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 54651263 . This is a "MEDICAID-AAIHB PUEBLO AUDIOLOGY" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: H7890 . This is a "AIHC MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: HSZ189 . This is a "TPSU MEDICARE PART B" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: HSZ841YRUF . This is a "PROVIDER MEDICARE PTAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: H7890 . This is a "SANDIAPHC MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: L9815 . This is a "CANONCITOHC MEDICAID" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".




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