Individual provider Active NPI

Emily Grace Buitron Courter, AU.D.

  • Audiologist
  • Jackson, MI
National Provider Identifier
1174217418
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601001109 Issued in MI
Practice address
1111 Teneyck St Ste 100
Jackson, MI 49201-2493
Phone
(517) 205-8940
Fax
(517) 205-0108
NPI assigned
Jun 8, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601001109 MI Primary

Addresses

Primary practice location

1111 Teneyck St Ste 100
Jackson, MI 49201-2493

Mailing address

1111 Teneyck St Ste 100
Jackson, MI 49201-2493
Phone (517) 205-8940

Other names 1

  • Emily Grace Courter Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230621002478 MI Practitioner - Qualified Audiologist 3072971126 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
W.a. Foote Memorial Hospital, Inc Audiologist CurrentSince Jun 19, 2023 Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jun 19, 2023 Accepting new patients
Wa Foote Memorial Hospital, Inc Audiologist Current Accepting new patients

Locations

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

1111 Teneyck St
Jackson, MI 49201
Phone (517) 205-8940

1111 Teneyck St
Ste 100
Jackson, MI 49201
Phone (517) 205-8940

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

Interoperability endpoints

  • Direct secure messaging: ebuitroncourter854740@direct.hfhs.org

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, 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": "1686182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1174217418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 TENEYCK ST STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012493",
            "telephone_number": "517-205-8940",
            "fax_number": "517-205-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 TENEYCK ST STE 100",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012493",
            "telephone_number": "517-205-8940",
            "fax_number": "517-205-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUITRON COURTER",
        "first_name": "EMILY",
        "middle_name": "GRACE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-08",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601001109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "COURTER",
            "middle_name": "GRACE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.