Organization Active NPI

Professional Hearing Services, LTD

  • Audiologist
  • Saint Joseph, MI
National Provider Identifier
1396703971
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
PROFESSIONAL HEARING SERVICES, LTD
Practice address
511 Renaissance Dr
Ste 100
Saint Joseph, MI 49085-2180
Phone
(269) 982-3444
Fax
(269) 982-3445
NPI assigned
May 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Mrs. Kimberly Ann Rice
Title
A/R Manager
Phone
(269) 982-3444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

511 Renaissance Dr
Ste 100
Saint Joseph, MI 49085-2180

Mailing address

511 Renaissance Dr
Ste 100
Saint Joseph, MI 49085-2180
Phone (269) 982-3444

Other identifiers 2

IdentifierTypeStateIssuer
640A126030OtherBLUE CROSS BLUE SHIELD MI
0A12603OtherMIMEDICARE ADVANTAGE BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111205000030 MI Part B Supplier - Clinic/Group Practice 5496920373 Receives reassigned benefits from 3 practitioners
Practice locations: Saint Joseph, MI

National Provider Directory

National Provider Directory

Locations

511 Renaissance Dr
Ste 100
Saint Joseph, MI 49085
Phone (269) 982-3444

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1396703971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 RENAISSANCE DR",
            "address_2": "STE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852180",
            "telephone_number": "269-982-3444",
            "fax_number": "269-982-3445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 RENAISSANCE DR",
            "address_2": "STE 100",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490852180",
            "telephone_number": "269-982-3444",
            "fax_number": "269-982-3445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEARING SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "A/R MANAGER",
        "authorized_official_telephone_number": "269-982-3444",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MI",
            "identifier": "640A126030",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ADVANTAGE BCBS",
            "identifier": "0A12603",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; 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.