BETHANY WYSOCKI (NPI# 1467012872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467012872 |
| Entity Type | Individual |
| Full Name | BETHANY WYSOCKI |
| Credential | AUD |
| Practice Address |
9555 Upland Ln N Maple Grove MN 55369-4485 |
| Mailing Address |
9824 Chestnut Ln Indianapolis IN 46239-9363 |
| Practice Telephone | 9529931440 |
| Mailing Telephone | 3176795420 |
| Enumeration Date | 2019-06-18 |
| Last Update Date | 2019-06-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | Speech, Language and Hearing Service Providers |
| Street Address |
9555 UPLAND LN N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4485 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568453926 | David C Sandell | Family Medicine | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2005-11-03 |
| 1114528593 | Dana Marie Feia | Physician Assistant | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2020-11-03 |
| 1235741364 | Relevium Chiropractic Care Pa | Chiropractor | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2020-08-19 |
| 1487168357 | Dusty Renee Hackler | Psychologist | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2017-11-29 |
| 1841722469 | Brynne Rainier Wilson Latterell | Family Medicine | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2017-04-02 |
| 1982150728 | Park Nicollet | Clinic/Center | 9555 Upland Ln N, Maple Grove, MN 66369 | 2016-08-31 |
| 1528514932 | David Chollar | Social Worker | 9555 Upland Ln N, Behavioral Health, 3rd Floor, Maple Grove, MN 55369-4485 | 2016-08-27 |
| 1770037574 | Biye Tambang | Nurse Practitioner | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2016-08-09 |
| 1174975528 | Park Nicollet | Clinic/Center | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2016-07-11 |
| 1780038299 | Elizabeth Patricia Kratz | Nurse Practitioner | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2016-04-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801011655 | Katherine Ann Young | Audiologist | 7270 Forestview Ln N Ste 225, Maple Grove, MN 55369 | 2007-04-16 |
| 1144355488 | Wanda Kay Crawford | Audiologist | 7270 Forestview Ln N Ste 160, Maple Grove, MN 55369-5698 | 2007-02-23 |
| 1013463876 | Katherine Lynn Awoyinka | Audiologist | 9825 Hospital Drive, Suite Ll-10, Maple Grove, MN 55369-4819 | 2016-08-31 |
| 1861945453 | Jka5 Maple Grove Inc | Audiologist | 7270 Forestview Ln N, 225, Maple Grove, MN 55369-5546 | 2016-07-29 |
| 1558749176 | Connect Hearing, Inc. | Audiologist | 7830 Main St N, 225, Maple Grove, MN 55369-7208 | 2015-05-14 |
| 1356757637 | Ashley Waldock | Audiologist | 9825 Hospital Dr, Suite Ll-10, Maple Grove, MN 55369-4479 | 2014-07-07 |
| 1952661357 | Bridget Miskowiec Carlson | Audiologist | 9825 Hospital Dr, Suite Ll 10, Maple Grove, MN 55369-4479 | 2012-05-21 |
| 1215264460 | Jennifer Anfinson Reekers | Audiologist | 7270 Forestview Ln N Ste 160, Maple Grove, MN 55369-5698 | 2009-11-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839715 | Thomas J Tedeschi | Audiologist | 150 S 5th St Ste 2300, Minneapolis, MN 55402-4223 | 2020-04-13 |
| 1902435514 | Robert Lang | Audiologist | 1597 Park Ave, White Bear Lake, MN 55110-3704 | 2020-04-06 |
| 1528625290 | Kara Rae Balken | Audiologist | 7300 France Ave S Ste 101, Edina, MN 55435-4525 | 2019-05-28 |
| 1538724612 | Elizabeth Mary Butler | Audiologist | 1155 E County Road E, Ste 100, Minneapolis, MN 55110-5191 | 2019-05-05 |
| 1417422445 | Joelle Peterson | Audiologist | 12925 16th Ave N, Plymouth, MN 55441-4560 | 2018-10-05 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1700313681 | Hannah Catherine Erickson Herd | Audiologist | 701 25th Ave S Fl 2, Minneapolis, MN 55454 | 2017-05-22 |
| 1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1457711327 | Reynolds Audiology LLC | Audiologist | 2155 Woodlane Drive, Suite 103, Woodbury, MN 55125-3049 | 2016-03-04 |
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| City | MAPLE GROVE |
| Zip Code | 55369 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.