Organization Active NPI

Lifetime Hearing LLC

  • Audiologist
  • Marysville, MI
National Provider Identifier
1043785355
Registry record updated Dec 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
LIFETIME HEARING LLC
Practice address
1273 Gratiot Blvd Ste 2
Marysville, MI 48040-2303
Phone
(810) 364-1170
NPI assigned
Oct 12, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2018

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

Authorized official

Name
Jeanette Lynn Dossin, AUDNPI 1487634945
Title
Audiologist
Phone
(810) 252-0339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

1273 Gratiot Blvd Ste 2
Marysville, MI 48040-2303

Mailing address

1273 Gratiot Blvd Ste 2
Marysville, MI 48040-2303
Phone (810) 364-1170

Other names 1

  • Lifetime Hearing Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181212000459 MI Part B Supplier - Clinic/Group Practice 3971847328 Receives reassigned benefits from 2 practitioners
Practice locations: Marysville, MI

National Provider Directory

National Provider Directory

Locations

1273 Gratiot Blvd
Ste 2
Marysville, MI 48040
Phone (810) 364-1170

1273 Gratiot Blvd
Marysville, MI 48040
Phone (810) 364-1170

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1539302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544486400000",
    "number": "1043785355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1273 GRATIOT BLVD STE 2",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402303",
            "telephone_number": "810-364-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1273 GRATIOT BLVD STE 2",
            "city": "MARYSVILLE",
            "state": "MI",
            "postal_code": "480402303",
            "telephone_number": "810-364-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME HEARING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-12",
        "last_updated": "2018-12-11",
        "status": "A",
        "authorized_official_last_name": "DOSSIN",
        "authorized_official_first_name": "JEANETTE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "810-252-0339",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifetime Hearing Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marysville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; 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.