Active NPI
Michanne Alexis Davidson, AU.D.
- Audiologist
- Coral Springs, FL
National Provider Identifier
1346490018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AY 376
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100917000887 | FL | Practitioner - Qualified Audiologist | 4789709452 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AY 376 | FL | MD | Audiologist |
| AS4981 | FL | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hearing AIDS for Active Life Inc | Hearing Instrument Specialist | Current | Accepting new patients |
| Audiology Associates of South Florida Inc. | Audiologist | Past | Accepting new patients |
| Hearusa Inc | Past | 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.
-
dba Active Life Hearing
- Hearing Instrument Specialist
- Coral Springs, FL
- NPI 1972165165
-
- Audiologist
- Coral Springs, FL
- NPI 1952471732
-
- Audiologist-Hearing Aid Fitter
- West Palm Beach, FL
- NPI 1073560231
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.