NPIMap

Organization Active NPI

Genesee ENT Associates, PC

  • Hearing Aid Equipment
  • Burton, MI
National Provider Identifier
1144511312
Registry record updated Apr 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Aid EquipmentTaxonomy code 332S00000X
License
1601000320 Issued in MI
Legal business name
GENESEE ENT ASSOCIATES, PC
Practice address
1501 S Center Rd
BLDG B
Burton, MI 48509-1731
Phone
(810) 742-0225
Fax
(810) 742-7990
NPI assigned
Apr 22, 2011
Last updated
Apr 22, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2011

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

Authorized official

Name
Dr. Khaled Shukairy, M.D.NPI 1518961879
Title
Owner/President
Phone
(810) 742-0225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X 1601000320 MI Primary

Addresses

Primary practice location

1501 S Center Rd
BLDG B
Burton, MI 48509-1731

Mailing address

1501 S Center Rd
BLDG B
Burton, MI 48509-1731
Phone (810) 742-0225

Other identifiers 2

IdentifierTypeStateIssuer
805367063MedicaidMI
1601000320OtherMISTATE OF MICHIGAN MI HEALTH PROF LICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303430400000",
    "number": "1144511312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BLDG B",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-742-0225",
            "fax_number": "810-742-7990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BLDG B",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-742-0225",
            "fax_number": "810-742-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESEE ENT ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2011-04-22",
        "status": "A",
        "authorized_official_last_name": "SHUKAIRY",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "810-742-0225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": "MI",
            "license": "1601000320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805367063",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN MI HEALTH PROF LICENSE",
            "identifier": "1601000320",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2011; 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.