Karissa L. Jagacki, AU.D.,CCC-A

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

1601000113 Issued in MI

Practice address

35337 Warren Rd
Westland, MI 48185-2013

Phone

(734) 467-5100

Fax

(734) 467-5103

NPI assigned

Sep 15, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Personalized Hearing Care

  • Audiologist-Hearing Aid Fitter
  • South Lyon, MI
  • NPI 1447591284
  NPD Authorized official
• Dennis & David Company

  • Optometrist
  • Bingham Farms, MI
  • NPI 1730153982
  NPD (past)

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209600000000",
    "number": "1164528246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20956 OAK TREE DR",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481787068",
            "telephone_number": "248-444-0674",
            "fax_number": "734-467-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35337 WARREN RD",
            "city": "WESTLAND",
            "state": "MI",
            "postal_code": "481852013",
            "telephone_number": "734-467-5100",
            "fax_number": "734-467-5103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAGACKI",
        "first_name": "KARISSA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "AU.D.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2008-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-SERVICES",
            "identifier": "640H227530",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4704347",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS-HEARING AIDS",
            "identifier": "540H104260",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4433772",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK PIN",
            "identifier": "0H10426",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Jackson
• Vanessa L Jackson
• Sarah Jacobi, DPT
• Claire Nicole Jacobs, LMSW
• George Cary Jacobs, RPH
• Pragya Jalukar, RPT
• Abdulhaseeb Khan Jameel, DDS
• James W O'Dell D.C. P.C.
• Jovan Syrece Jamison
• Brieanna Jarrett

• Audiologist-Hearing Aid Fitter in Westland, MI
• Providers in Westland, MI by specialty
• Audiologist-Hearing Aid Fitter in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.