Active NPI
Mary Helen Potts, M.A., CCC-A
- Audiologist
- Fairview Park, OH
National Provider Identifier
1396856712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A-00904
- Practice address
- 21732 Lorain Rd
Fairview Park, OH 44126-3329 - Phone
- (440) 333-0606
- Fax
- (440) 333-3855
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | A00904 | OH | |
| Audiologist | 231H00000X | A-00904 | OH | Primary |
Addresses
Primary practice location
21732 Lorain Rd
Fairview Park, OH 44126-3329
Mailing address
750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-00904 | OH | MD | Audiologist |
| A00904 | OH | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Hearing Inc | Audiologist | Current | Accepting new patients |
| Connect Hearing, Inc. | Audiologist | Past | Accepting new patients |
Locations
750 N Commons Dr
Ste 200
Aurora, IL 60504
215 Shuman Blvd
Ste 401
Naperville, IL 60563
Phone (331) 229-8279
21732 Lorain Rd
Fairview Park, OH 44126
Phone (440) 333-0606
Organizations & group practices 2
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": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596412800000",
"number": "1396856712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 N COMMONS DR STE 200",
"city": "AURORA",
"state": "IL",
"postal_code": "605047940",
"telephone_number": "630-303-5380",
"fax_number": "630-303-5385"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21732 LORAIN RD",
"city": "FAIRVIEW PARK",
"state": "OH",
"postal_code": "441263329",
"telephone_number": "440-333-0606",
"fax_number": "440-333-3855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTS",
"first_name": "MARY",
"middle_name": "HELEN",
"name_prefix": "Mrs.",
"credential": "M.A., CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2020-08-03",
"certification_date": "2020-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "OH",
"license": "A00904",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OH",
"license": "A-00904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairview Park, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.