Individual provider Active NPI

Stacey Simon, M.S.,CCC-A

  • Audiologist
  • Warren, MI
National Provider Identifier
1023242039
Registry record updated May 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000169 Issued in MI
Practice address
27301 Schoenherr Rd Ste 105
Warren, MI 48088-6649
Phone
(586) 756-4009
Fax
(586) 756-3855
NPI assigned
May 5, 2009
Last updated
May 5, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000169 MI Primary

Addresses

Primary practice location

27301 Schoenherr Rd Ste 105
Warren, MI 48088-6649

Mailing address

7577 Windgate Cir
West Bloomfield, MI 48323-3911
Phone (248) 926-1586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1601000169MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Hearing Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241481600000",
    "number": "1023242039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7577 WINDGATE CIR",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483233911",
            "telephone_number": "248-926-1586",
            "fax_number": "248-926-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27301 SCHOENHERR RD STE 105",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886649",
            "telephone_number": "586-756-4009",
            "fax_number": "586-756-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "STACEY",
        "credential": "M.S.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.