Provider Demographics
NPI:1386649283
Name:ORMSON, KERRY D (EDD, AUD)
Entity Type:Individual
Prefix:DR
First Name:KERRY
Middle Name:D
Last Name:ORMSON
Suffix:
Gender:M
Credentials:EDD, AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4131
Mailing Address - Country:US
Mailing Address - Phone:806-468-4343
Mailing Address - Fax:806-468-4366
Practice Address - Street 1:5501 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4131
Practice Address - Country:US
Practice Address - Phone:806-468-4343
Practice Address - Fax:806-468-4366
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50313231H00000X, 237600000X, 231HA2400X, 231HA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Practitioner
Not Answered231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX505717Medicare ID - Type Unspecified
TXR64696Medicare UPIN