Individual provider Active NPI

Douglas W Capparelli, BC-HIS

  • Hearing Instrument Specialist
  • Vancouver, WA
National Provider Identifier
1114057411
Registry record updated Oct 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA 60325844 Issued in WA
Practice address
11516 SE Mill Plain Blvd Ste 2J
Vancouver, WA 98684-5082
Phone
(360) 882-8027
Fax
(360) 882-8030
NPI assigned
Mar 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HAS-P-1001628 OR
Hearing Instrument Specialist 237700000X HA 60325844 WA Primary

Addresses

Primary practice location

11516 SE Mill Plain Blvd Ste 2J
Vancouver, WA 98684-5082

Mailing address

6724 SE 114TH Ave
Portland, OR 97266-4966
Phone (503) 421-6094

Other identifiers 1

IdentifierTypeStateIssuer
2031096MedicaidWA

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

LicenseStateTypeSpecialty
HAS-P-1001628ORMDHearing Instrument Specialist
HA 60325844WAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC PastSince Apr 21, 2023 Accepting new patients
Hearx West, LLC Past Accepting new patients

Organizations & group practices 2

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": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382313600000",
    "number": "1114057411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 SE 114TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972664966",
            "telephone_number": "503-421-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11516 SE MILL PLAIN BLVD STE 2J",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986845082",
            "telephone_number": "360-882-8027",
            "fax_number": "360-882-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPARELLI",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "BC-HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2013-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "OR",
            "license": "HAS-P-1001628",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "WA",
            "license": "HA 60325844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2031096",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2013; 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.