Individual provider Active NPI

Marian Henniges, AU.D.

  • Audiologist
  • Greenwich, CT
National Provider Identifier
1184668949
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
000922 Issued in NY
Practice address
4 Dearfield Dr
Suite 104
Greenwich, CT 06831-5351
Phone
(203) 629-5500
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 000922 NY Primary

Addresses

Primary practice location

4 Dearfield Dr
Suite 104
Greenwich, CT 06831-5351

Mailing address

4 Dearfield LN 104
Greenwich, CT 06831-5326
Phone (203) 629-5500

Other names 1

  • Marian Phillips Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000922NYMDPsychoanalysis Psychologist
000037CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearusa Inc Past Accepting new patients
Greenwich Otolaryngology, PC PastSince Sep 1, 2000 Accepting new patients
Audiology Distribution, LLC PastSince Aug 14, 2014 Accepting new patients

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1184668949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 DEARFIELD LN 104",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315326",
            "telephone_number": "203-629-5500",
            "fax_number": "203-629-8244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 DEARFIELD DR",
            "address_2": "SUITE 104",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068315351",
            "telephone_number": "203-629-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNIGES",
        "first_name": "MARIAN",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-15",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NY",
            "license": "000922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIAN",
            "last_name": "PHILLIPS",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.