Active NPI
Patricia Roach
- Hearing Instrument Specialist
- Saint Clair Shores, MI
National Provider Identifier
1255886305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 3501006963
- Practice address
- 22631 Greater Mack Ave
Ste 100
Saint Clair Shores, MI 48080-2055 - Phone
- (586) 252-2914
- Fax
- (586) 252-2918
- NPI assigned
- Aug 18, 2016
- 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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 3501006963 | MI | Primary |
Addresses
Primary practice location
22631 Greater Mack Ave
Ste 100
Saint Clair Shores, MI 48080-2055
Mailing address
22631 Greater Mack Ave
Ste 100
Saint Clair Shores, MI 48080-2055
Phone (586) 252-2914
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3501006963 | MI | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471478400000",
"number": "1255886305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22631 GREATER MACK AVE",
"address_2": "STE 100",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480802055",
"telephone_number": "586-252-2914",
"fax_number": "586-252-2918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22631 GREATER MACK AVE",
"address_2": "STE 100",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480802055",
"telephone_number": "586-252-2914",
"fax_number": "586-252-2918"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROACH",
"first_name": "PATRICIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-18",
"last_updated": "2016-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MI",
"license": "3501006963",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.