Individual provider Active NPI

Marcy K Hite, AU.D., PH.D., CCC-A

  • Audiologist
  • Johnson City, TN
National Provider Identifier
1417298969
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
SP1853 Issued in TN
Practice address
156 South Dossett Drive
Johnson City, TN 37614-1702
Phone
(423) 439-4355
Fax
(423) 439-4607
NPI assigned
Mar 8, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 80449 TX
Audiologist 231H00000X SP1853 TN Primary

Addresses

Primary practice location

156 South Dossett Drive
Johnson City, TN 37614-1702

Mailing address

PO Box 699
Mountain Home, TN 37684-0699
Phone (423) 439-4584

Other practice location 1

3601 4th St
Ste. 2A300
Lubbock, TX 79430-0002
Phone (806) 743-5678

Other practice location 2

1000 Jason Witten Way
Elizabethton, TN 37643-2970
Phone (423) 439-4355

Other practice location 3

2151 Century Lane
Johnson City, TN 37604-4469
Phone (423) 926-2500

Other practice location 4

325 N. State of Franklin Road
Ground Floor
Johnson City, TN 37604-6062
Phone (423) 439-7320

Other identifiers 4

IdentifierTypeStateIssuer
Q034178MedicaidTN
80449OtherTXTEXAS LICENSURE
14062359OtherMDASHA BOARD CERTIFICATE
SP1853OtherTNSTATE OF TENNESSEE DEPARTMENT OF HEALTH DIVISION OF HEALTH LICENSURE AND REGULAT

Other names 1

  • Marcy K Lau Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181213000688 TN Practitioner - Qualified Audiologist 7012154644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1000 Jason Witten Way
Elizabethton, TN 37643-2970
Phone (423) 439-4355

BLDG 52 Lake Dr
Mountain Home, TN 37684-0001
Phone (423) 439-8000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
SP1853TNMDAudiologist
1853TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Education Assistance Corporation CurrentSince May 1, 2019 Accepting new patients
East Tennessee State University Past Accepting new patients

Locations

1000 Jason Witten Way
Elizabethton, TN 37643
Phone (423) 547-4915

325 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 439-7280

400 E State of Franklin Rd
Johnson City, TN 37601
Phone (423) 433-6200

2151 Century Ln
Johnson City, TN 37604
Phone (423) 439-4071

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1362700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1417298969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-4584",
            "fax_number": "423-439-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 SOUTH DOSSETT DRIVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141702",
            "telephone_number": "423-439-4355",
            "fax_number": "423-439-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 4th St",
            "address_2": "Ste. 2A300",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794300002",
            "country_code": "US",
            "telephone_number": "806-743-5678",
            "fax_number": "806-743-5670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Jason Witten Way",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432970",
            "country_code": "US",
            "telephone_number": "423-439-4355",
            "fax_number": "423-439-4607",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2151 Century Lane",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376044469",
            "country_code": "US",
            "telephone_number": "423-926-2500",
            "fax_number": "423-926-5999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 N. State of Franklin Road",
            "address_2": "Ground Floor",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046062",
            "country_code": "US",
            "telephone_number": "423-439-7320",
            "fax_number": "423-439-7343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HITE",
        "first_name": "MARCY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "AU.D., PH.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-08",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "80449",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "SP1853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q034178",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS LICENSURE",
            "identifier": "80449",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA BOARD CERTIFICATE",
            "identifier": "14062359",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TENNESSEE DEPARTMENT OF HEALTH DIVISION OF HEALTH LICENSURE AND REGULAT",
            "identifier": "SP1853",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARCY",
            "last_name": "LAU",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.