Individual provider Active NPI

Courtney McLeod

  • Audiologist
  • Waterford, CT
National Provider Identifier
1144971144
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
000683 Issued in CT
Practice address
167 Waterford Pkwy N
Waterford, CT 06385-1200
Phone
(800) 443-6944
NPI assigned
Jan 12, 2022
Last updated
Jan 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000683 CT Primary

Addresses

Primary practice location

167 Waterford Pkwy N
Waterford, CT 06385-1200

Mailing address

3 Wells St
Groton, CT 06340-3336
Phone (508) 728-4568

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225001830 CT Practitioner - Qualified Audiologist 9032503503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoreline Audiology, LLCGroup PAC ID 0446343461, 2 clinicians

Practice addresses (Care Compare)

495 Route 184
Suite 208
Groton, CT 06340-6229
Phone (860) 445-7476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000683CTMDProfessional Counselor
683CTMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
County Hearing and Balance, Inc. Audiologist PastSince Jan 21, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641945600000",
    "number": "1144971144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WELLS ST",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403336",
            "telephone_number": "508-728-4568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 WATERFORD PKWY N",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851200",
            "telephone_number": "800-443-6944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEOD",
        "first_name": "COURTNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.