Nathan Forrest Danneker

Primary specialty

AudiologistTaxonomy code 231H00000X

Practice address

149 Plantation Ridge Dr Ste 190
Mooresville, NC 28117-9178

Phone

(704) 658-0595

Fax

(704) 658-0916

NPI assigned

Jul 7, 2020

Last updated

Apr 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Evergreen Hearing Clinic IncGroup PAC ID 3577450931, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Evergreen Hearing Clinic Inc

  dba Evergreen Speech and Hearing Clinic Inc

  • Audiologist
  • Redmond, WA
  • NPI 1013934918
  Medicare reassignment Care Compare group NPD
• Evergreen Speech Clinic, Inc

  dba Evergreen Speech and Hearing Clinic, Inc

  • Clinic/Center
  • Redmond, WA
  • NPI 1346474731
  NPD (past)

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1235757220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PLANTATION RIDGE DR STE 190",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179178",
            "telephone_number": "704-658-0595",
            "fax_number": "704-658-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 PLANTATION RIDGE DR STE 190",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179178",
            "telephone_number": "704-658-0595",
            "fax_number": "704-658-0916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANNEKER",
        "first_name": "NATHAN",
        "middle_name": "FORREST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-07-07",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ndanneker18839@direct.ceenta.com",
            "affiliation": "N",
            "address_1": "149 Plantation Ridge Dr Ste 190",
            "city": "Mooresville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "281179178",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephanie Kelley Czyryca, MSW
• Doreen Joy Daneault, OTR/L
• Ariel Catherine Danek, MS, RD, LDN, CDCES
• Latoya Camp Daniels, MSW, LSCW-A
• Shelby Daniels
• Darren R. Cross DDS, PLLC
• Susan Moore Daubenmire, MA, CCC-SLP
• David E Thome DDS PLLC I (Mooresville Pediatric Dentistry)
• David E Thome DDS PLLC II (Mooresville Pediatric Dentistry)
• David E Thome DDS PLLC L1

• Audiologist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Audiologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.