Individual provider Active NPI

Marissa Land, AUD

  • Audiologist
  • Smithfield, NC
National Provider Identifier
1144637836
Registry record updated Aug 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
15008 Issued in NC
Practice address
1652 E Booker Dairy Rd
Smithfield, NC 27577-9405
Phone
(919) 300-5438
Fax
(919) 364-1726
NPI assigned
Jul 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 15008 NC
Audiologist 231H00000X 15008 NC Primary

Addresses

Primary practice location

1652 E Booker Dairy Rd
Smithfield, NC 27577-9405

Mailing address

1652 E Booker Dairy Rd
Smithfield, NC 27577-9405
Phone (919) 300-5438

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220902002315 NC Practitioner - Qualified Audiologist 0244451938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coates Hearing Clinic PAGroup PAC ID 3678818077, 6 clinicians

Practice addresses (Care Compare)

1652 E Booker Dairy Rd
Smithfield, NC 27577-9405
Phone (919) 300-5438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15008NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coates Hearing Clinic, PA Audiologist CurrentSince Aug 25, 2022 Accepting new patients
Koch Hearing LLC Audiologist CurrentSince Aug 1, 2022 Accepting new patients
Vrooman Audiology, PLLC Audiologist PastSince Aug 1, 2022 Accepting new patients

Locations

2400 Wayne Memorial Dr
Ste C
Goldsboro, NC 27534
Phone (919) 751-6053

7718 Six Forks Rd
Ste 102
Raleigh, NC 27615
Phone (919) 670-3777

1652 E Booker Dairy Rd
Smithfield, NC 27577
Phone (330) 412-4405

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": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660694400000",
    "number": "1144637836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 E BOOKER DAIRY RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779405",
            "telephone_number": "919-300-5438",
            "fax_number": "919-364-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1652 E BOOKER DAIRY RD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275779405",
            "telephone_number": "919-300-5438",
            "fax_number": "919-364-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAND",
        "first_name": "MARISSA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NC",
            "license": "15008",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "15008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithfield, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.