Provider Demographics
NPI:1821375361
Name:POWELL, TODD ANDREW (AUD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:ANDREW
Last Name:POWELL
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 PROSPECT PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-4311
Mailing Address - Country:US
Mailing Address - Phone:505-764-0036
Mailing Address - Fax:505-764-0446
Practice Address - Street 1:7001 PROSPECT PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-764-0036
Practice Address - Fax:505-764-0446
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5007237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMHSZ178OtherSANTA FE INDIAN HOSPITAL MEDICARE PIN
NMHSZ181OtherCOCHITI PUEBLO HEALTH CLINIC MEDICARE PIN
NMK1576OtherMEDICAID-TRIBAL AUDIOLOGY AAIHB
NM320070OtherCANONCITOHC OSCAR/CERTIFICATION
NMH1232OtherSANFELIPEPHC MEDICAID
NM82674060OtherKEWA PHC MEDICAID
NMH1232OtherCOCHITI HEALTH CLINIC AND SANTA FE INDIAN HOSPITAL MEDICAID
NMHSZ022OtherCANONCITOHC MEDICARE PIN
NMHSZ164OtherSANDIAPHC MEDICARE
NMPHS000OtherALBUQUERQUE MEDICARE UPIN
NMTR2037OtherKEWA PHC MEDICARE PLAN B
NM320056OtherAIHC MEDICARE UNSPECIFIED
NM320057OtherSANTA FE INDIAN HOSPITAL MEDICARE O/C
NM320057OtherCOCHITI HEALTH CLINIC AND SANTA FE INDIAN HOSPITAL MEDICARE O/C
NM54651263OtherMEDICAID-AAIHB PUEBLO AUDIOLOGY
NMH7890OtherAIHC MEDICAID
NMHSZ189OtherTPSU MEDICARE PART B
NMHSZ841YRUFOtherPROVIDER MEDICARE PTAN
NMH7890OtherSANDIAPHC MEDICAID
NML9815OtherCANONCITOHC MEDICAID
NM31174256OtherSANTAANAPHC MEDICAID
NM320057OtherTPSU MEDICARE PART A
NM320057OtherSANFELIPEPHC MEDICARE OSCAR/CERTIFICATION
NM63476274Medicaid
NMHSZ159OtherSANTAANAPHC OTHER
NMHSZ180OtherSANFELIPEPHC MEDICARE PIN
NMK3543OtherTPSU MEDICAID