Provider Demographics
NPI:1073747556
Name:MARTIN, KARA ELIZABETH (AUD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:ELIZABETH
Last Name:MARTIN
Suffix:
Gender:
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 STILLHOUSE RUN
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-3880
Mailing Address - Country:US
Mailing Address - Phone:304-698-6278
Mailing Address - Fax:
Practice Address - Street 1:120 STILLHOUSE RUN
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24503-3880
Practice Address - Country:US
Practice Address - Phone:304-698-6278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001396231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1073747556Medicaid
VAVAA103247OtherMEDICARE PALMETTO GBA PTAN (DANNY W. GNEWIKOW, PH.D., LLC)
VAP01117663OtherMEDICARE RAILROAD PTAN - AUDIOLOGY HEARING AID ASSOCIATES, INC.
VAVAA103248OtherMEDICARE PALMETTO GBA PTAN (AUDIOLOGY HEARING AID ASSOCIATES, INC.)