Active NPI
Jo Manette Kathleen Nousak, PH. D.
- Audiologist-Hearing Aid Fitter
- Syracuse, NY
National Provider Identifier
1225213614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- 000813-1
- Practice address
- 170 Intrepid LN
Syracuse, NY 13205-2545 - Phone
- (315) 492-8319
- NPI assigned
- Jan 3, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 000813-1 | NY | Primary |
Addresses
Primary practice location
170 Intrepid LN
Syracuse, NY 13205-2545
Mailing address
170 Intrepid LN
Syracuse, NY 13205-2545
Phone (315) 492-8319
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000813-1 | NY | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199318400000",
"number": "1225213614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 INTREPID LN",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052545",
"telephone_number": "315-492-8319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 INTREPID LN",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052545",
"telephone_number": "315-492-8319"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOUSAK",
"first_name": "JO MANETTE",
"middle_name": "KATHLEEN",
"name_prefix": "Ms.",
"credential": "PH. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-03",
"last_updated": "2008-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "NY",
"license": "000813-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.