Organization Active NPI

Covington Hearing Associates, LLC

  • Hearing Aid Equipment
  • Covington, GA
National Provider Identifier
1265958078
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Aid EquipmentTaxonomy code 332S00000X
Legal business name
COVINGTON HEARING ASSOCIATES, LLC
Practice address
4165 Hospital Dr NE
Covington, GA 30014-2565
Phone
(470) 441-6333
Fax
(470) 389-6265
NPI assigned
Aug 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Jacqueline Susann Shriver, CCC-A, FAAANPI 1699938621
Title
Clinical Audiologist
Phone
(470) 441-6333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Aid Equipment 332S00000X Primary

Addresses

Primary practice location

4165 Hospital Dr NE
Covington, GA 30014-2565

Mailing address

4165 Hospital Dr NE
Covington, GA 30014-2565
Phone (470) 441-6333

Other identifiers 1

IdentifierTypeStateIssuer
000790072CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180711004049 GA Part B Supplier - Clinic/Group Practice 0941556591 Receives reassigned benefits from 1 practitioner
Practice locations: Covington, GA

National Provider Directory

National Provider Directory

Locations

4165 Hospital Dr NE
Covington, GA 30014
Phone (470) 441-6333

Practitioners & affiliated clinicians

Practitioners 6

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": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265958078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4165 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142565",
            "telephone_number": "470-441-6333",
            "fax_number": "470-389-6265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4165 HOSPITAL DR NE",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300142565",
            "telephone_number": "470-441-6333",
            "fax_number": "470-389-6265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVINGTON HEARING ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SHRIVER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "SUSANN",
        "authorized_official_title_or_position": "CLINICAL AUDIOLOGIST",
        "authorized_official_telephone_number": "470-441-6333",
        "authorized_official_credential": "CCC-A, FAAA"
    },
    "taxonomies": [
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000790072C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.