Active NPI
Lori Davis-Nettles
- Hearing Instrument Specialist
- Kokomo, IN
National Provider Identifier
1033668488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 174001470
- Practice address
- 1601 W Lincoln Rd
Kokomo, IN 46902 - Phone
- (765) 453-5696
- Fax
- (765) 455-4323
- NPI assigned
- Sep 27, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 174001470 | IN | Primary |
Addresses
Primary practice location
1601 W Lincoln Rd
Kokomo, IN 46902
Mailing address
PO Box 549
Wabash, IN 46992-0549
Phone (765) 453-5696
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174001470 | IN | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534291200000",
"number": "1033668488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 549",
"city": "WABASH",
"state": "IN",
"postal_code": "469920549",
"telephone_number": "765-453-5696",
"fax_number": "765-455-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 W LINCOLN RD",
"city": "KOKOMO",
"state": "IN",
"postal_code": "46902",
"telephone_number": "765-453-5696",
"fax_number": "765-455-4323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS-NETTLES",
"first_name": "LORI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-27",
"last_updated": "2018-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IN",
"license": "174001470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kokomo, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.