Individual provider Active NPI

Marie A. Church, MASTER'S DEGREE

  • Audiologist
  • Blacksburg, VA
National Provider Identifier
1023260866
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201000327 Issued in VA
Practice address
3607 S Main St
Blacksburg, VA 24060-7014
Phone
(540) 381-6967
Fax
(540) 381-6968
NPI assigned
Oct 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 2101000520 VA
Audiologist 231H00000X 2201000327 VA Primary

Addresses

Primary practice location

3607 S Main St
Blacksburg, VA 24060-7014

Mailing address

85 Cleburne Blvd
Dublin, VA 24084-4435
Phone (540) 674-4889

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090723000518 VA Practitioner - Qualified Audiologist 9739231796 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201000327VAMDAudiologist
2101000520VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Tilley Chiropractic and Sports Injury Clinic Past Accepting new patients
The Hearing Clinic Audiologist PastSince Sep 15, 2015 Accepting new patients
Audigycare, LLC Audiologist-Hearing Aid Fitter Past Accepting new patients

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1023260866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 CLEBURNE BLVD",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240844435",
            "telephone_number": "540-674-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3607 S MAIN ST",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607014",
            "telephone_number": "540-381-6967",
            "fax_number": "540-381-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "MARIE",
        "middle_name": "A.",
        "credential": "MASTER'S DEGREE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": "2101000520",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.