NPIMap

Organization Active NPI

Las Davis Enterprises

Doing business as Miracle-Ear

  • Hearing Instrument Specialist
  • Waterloo, IL
National Provider Identifier
1235624867
Registry record updated Jun 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
Legal business name
LAS DAVIS ENTERPRISES
Doing business as
Miracle-Ear
Practice address
911 State Rte 3
Waterloo, IL 62298
Phone
(618) 844-1401
Fax
(618) 504-2086
NPI assigned
Jun 26, 2018
Last updated
Jun 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2018

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

Authorized official

Name
Tiffany DavisNPI 1558556662
Title
President
Phone
(314) 328-0088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 237700000X Primary

Addresses

Primary practice location

911 State Rte 3
Waterloo, IL 62298

Mailing address

4200 N Illinois
Suite D
Swansea, IL 62226
Phone (618) 234-7368

Other names 1

  • Miracle-Ear Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Las Davis Enterprises2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1529971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529971200000",
    "number": "1235624867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 N ILLINOIS",
            "address_2": "SUITE D",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "62226",
            "telephone_number": "618-234-7368",
            "fax_number": "618-416-1815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 STATE RTE 3",
            "city": "WATERLOO",
            "state": "IL",
            "postal_code": "62298",
            "telephone_number": "618-844-1401",
            "fax_number": "618-504-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS DAVIS ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-26",
        "last_updated": "2018-06-26",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-328-0088"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miracle-Ear",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waterloo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2018; 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.