Active NPI
David Wayne Powell, AU.D.
- Audiologist
- Rockford, IL
National Provider Identifier
1386697597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 147000948
- Practice address
- 6653 Weaver Rd Ste 116
Rockford, IL 61114-8068 - Phone
- (815) 315-7152
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 147000948 | IL | Primary |
Addresses
Primary practice location
6653 Weaver Rd Ste 116
Rockford, IL 61114-8068
Mailing address
12236 Sleepy Hollow Rd
Roscoe, IL 61073-9098
Phone (773) 339-4791
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 147000948 | IL | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Podiatry Group PC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Podiatrist
- Oak Harbor, WA
- NPI 1720037138
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688515200000",
"number": "1386697597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12236 SLEEPY HOLLOW RD",
"city": "ROSCOE",
"state": "IL",
"postal_code": "610739098",
"telephone_number": "773-339-4791"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6653 WEAVER RD STE 116",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611148068",
"telephone_number": "815-315-7152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POWELL",
"first_name": "DAVID",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-18",
"last_updated": "2023-07-05",
"certification_date": "2023-07-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "IL",
"license": "147000948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.