Individual provider Active NPI

Michanne Alexis Davidson, AU.D.

  • Audiologist
  • Coral Springs, FL
National Provider Identifier
1346490018
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY 376 Issued in FL
Practice address
2900 N University Dr Ste 76
Coral Springs, FL 33065-5083
Phone
(954) 994-4143
Fax
(954) 827-0591
NPI assigned
Sep 30, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AS4981 FL
Audiologist 231H00000X AY 376 FL Primary

Addresses

Primary practice location

2900 N University Dr Ste 76
Coral Springs, FL 33065-5083

Mailing address

10540 NW 56TH Dr
Coral Springs, FL 33076-2801
Phone (954) 994-4143

Other practice location 1

399 NW 2nd Ave Ste 214
Boca Raton, FL 33432-3848
Phone (561) 221-0450

Other names 1

  • Dr. Michanne Alexis Abbanat Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100917000887 FL Practitioner - Qualified Audiologist 4789709452

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY 376FLMDAudiologist
AS4981FLMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing AIDS for Active Life Inc Hearing Instrument Specialist Current Accepting new patients
Audiology Associates of South Florida Inc. Audiologist PastSince Feb 15, 2009 Accepting new patients
Hearusa Inc PastSince Feb 1, 2013 Accepting new patients

Locations

2855 N University Dr
Ste 300
Coral Springs, FL 33065
Phone (954) 317-0772

Organizations & group practices 3

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": "1222732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580428800000",
    "number": "1346490018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10540 NW 56TH DR",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330762801",
            "telephone_number": "954-994-4143",
            "fax_number": "954-827-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N UNIVERSITY DR STE 76",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655083",
            "telephone_number": "954-994-4143",
            "fax_number": "954-827-0591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "399 NW 2nd Ave Ste 214",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334323848",
            "country_code": "US",
            "telephone_number": "561-221-0450",
            "fax_number": "954-827-0591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "MICHANNE",
        "middle_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-30",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS4981",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY 376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHANNE",
            "last_name": "ABBANAT",
            "middle_name": "ALEXIS",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.