Active NPI
Northland US LLC
Doing business as Family Care Hearing
- Audiologist-Hearing Aid Fitter
- Carbondale, IL
National Provider Identifier
1285674200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- 2788
- Legal business name
- NORTHLAND US LLC
- Doing business as
- Family Care Hearing
- Practice address
- 1404 W Main St
Carbondale, IL 62901-2230 - Phone
- (618) 351-7179
- Fax
- (618) 519-9306
- NPI assigned
- Jun 7, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mark Holtz
- Title
- General Manager
- Phone
- (952) 486-8734
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 2788 | IL | Primary |
Addresses
Primary practice location
1404 W Main St
Carbondale, IL 62901-2230
Mailing address
1404 W Main St
Carbondale, IL 62901-2230
Phone (618) 351-7179
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2832016 | Other | IL | BLUE CROSS BLUE SHIELD IL |
Other names 1
- Family Care Hearing
National Provider Directory
National Provider Directory- Tax ID family
- Family Care Hearing
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Hearing Instrument Specialist
- Kansas City, MO
- NPI 1205968781
Locations
1404 W Main St
Carbondale, IL 62901
Phone (618) 351-7179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1285674200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1404 W MAIN ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629012230",
"telephone_number": "618-351-7179",
"fax_number": "618-519-9306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1404 W MAIN ST",
"city": "CARBONDALE",
"state": "IL",
"postal_code": "629012230",
"telephone_number": "618-351-7179",
"fax_number": "618-519-9306"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHLAND US LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-07",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HOLTZ",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "GENERAL MANAGER",
"authorized_official_telephone_number": "952-486-8734"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "IL",
"license": "2788",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD IL",
"identifier": "2832016",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Family Care Hearing",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Carbondale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.