Mary Lynn Vandrie, M.A.,CCC-A

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1601000092 Issued in MI

Practice address

705 W. Lake Lansing Road
East Lansing, MI 48823

Phone

(517) 337-2411

Fax

(517) 337-6033

NPI assigned

Jun 19, 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 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1978

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Western Michigan ENT PCGroup PAC ID 4688619406, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Western Michigan ENT PC

  • Specialist
  • Manistee, MI
  • NPI 1982672408
  Medicare reassignment Care Compare group
• Audiology Distribution, LLC

  • Audiologist-Hearing Aid Fitter
  • Dublin, OH
  • NPI 1164707998
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1174568422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406153",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841876",
            "telephone_number": "810-177-1385",
            "fax_number": "810-733-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W. LAKE LANSING ROAD",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-337-2411",
            "fax_number": "517-337-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDRIE",
        "first_name": "MARY",
        "middle_name": "LYNN",
        "credential": "M.A.,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174568422",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelly Lynn Vanaken, LMSW
• Caitlyn K Vanarman
• Nicole Therese Vanassche
• Delynn Vanatta, LMT
• Travis Vander Sloot
• Nichole K Vanells, CNP
• Karen Vanetten, DPT
• Mai G Vang, NP
• Sydney Vangessel
• Erika Marie Vanhoven, LLPC

• Audiologist in East Lansing, MI
• Providers in East Lansing, MI by specialty
• Audiologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.