Individual provider Active NPI

Sandy L Sian

  • Hearing Instrument Specialist
  • Grandville, MI
National Provider Identifier
1265697320
Registry record updated Sep 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
3501004909 Issued in MI
Practice address
4301 Canal Ave SW
Grandville, MI 49418-2667
Phone
(616) 257-7880
Fax
(616) 257-0580
NPI assigned
Jul 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X MI
Hearing Instrument Specialist 237700000X 3501004909 MI Primary

Addresses

Primary practice location

4301 Canal Ave SW
Grandville, MI 49418-2667

Mailing address

PO Box 406153
Atlanta, GA 30384-1876
Phone (561) 478-8770

Other names 1

  • Sandy L. Shelley 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3501004909MIMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC Audiologist-Hearing Aid Fitter Past Accepting new patients
Hearusa Inc Audiologist-Hearing Aid Fitter Past Accepting new patients

Organizations & group practices 2

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": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1265697320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406153",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841876",
            "telephone_number": "561-478-8770",
            "fax_number": "561-688-8877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 CANAL AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182667",
            "telephone_number": "616-257-7880",
            "fax_number": "616-257-0580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAN",
        "first_name": "SANDY",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-28",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MI",
            "license": "3501004909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDY",
            "last_name": "SHELLEY",
            "middle_name": "L.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.