Individual provider Active NPI

Terry L McIlvaine, AU.D.

  • Audiologist
  • Wooster, OH
National Provider Identifier
1043505233
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.02554 Issued in OH
Practice address
365 Riffel Rd Ste D
Wooster, OH 44691-8592
Phone
(330) 439-4106
Fax
(330) 345-3003
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000172 MI
Audiologist 231H00000X A.02554 OH Primary

Addresses

Primary practice location

365 Riffel Rd Ste D
Wooster, OH 44691-8592

Mailing address

365 Riffel Rd Ste D
Wooster, OH 44691-8592
Phone (330) 439-4106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120331000043 MI Practitioner - Qualified Audiologist 9739349069 Reassigns benefits to 1 organization
I20241217000147 OH Practitioner - Qualified Audiologist 9739349069 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000172MIMDAudiologist
A.02554OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC CurrentSince Oct 31, 2024 Accepting new patients
Professional Hearing Services, LTD Audiologist CurrentSince Mar 1, 2012 Accepting new patients
Audiology Services Company USA, LLC Audiologist CurrentSince Oct 31, 2024 Accepting new patients

Locations

511 Renaissance Dr
Ste 100
Saint Joseph, MI 49085
Phone (269) 982-3444

2501 Cottontail Ln
Somerset, NJ 08873
Phone (732) 529-7120

2169 Stringtown Rd
Grove City, OH 43123
Phone (614) 871-5555

836 N Lexington Springmill Rd
Ontario, OH 44906
Phone (419) 524-7968

888 E Court St
Urbana, OH 43078
Phone (937) 652-1144

365 Riffel Rd
Ste D
Wooster, OH 44691
Phone (330) 345-1050

Organizations & group practices 3

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1043505233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE D",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "330-439-4106",
            "fax_number": "330-345-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 RIFFEL RD STE D",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446918592",
            "telephone_number": "330-439-4106",
            "fax_number": "330-345-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCILVAINE",
        "first_name": "TERRY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000172",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.02554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.