Provider Demographics
NPI:1548302870
Name:MOUNTAIN PEAK HEARING ASSOCIATES, INC.
Entity type:Organization
Organization Name:MOUNTAIN PEAK HEARING ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KISER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A, FAAA
Authorized Official - Phone:303-425-3344
Mailing Address - Street 1:4045 WADSWORTH BLVD.
Mailing Address - Street 2:SUITE 290
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80033-4643
Mailing Address - Country:US
Mailing Address - Phone:303-425-3344
Mailing Address - Fax:303-425-7549
Practice Address - Street 1:4045 WADSWORTH BLVD.
Practice Address - Street 2:SUITE 290
Practice Address - City:WHEAT RIDGE
Practice Address - State:CO
Practice Address - Zip Code:80033-4643
Practice Address - Country:US
Practice Address - Phone:303-425-3344
Practice Address - Fax:303-425-7549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO62231H00000X, 231HA2400X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
Not Answered231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO668540OtherANTHEM BCBS PROVIDER #
CO509728Medicare ID - Type UnspecifiedMEDICARE PROVIDER #