Active NPI
Tayler Rae Fazil, AUD
- Audiologist
- Maryville, IL
National Provider Identifier
1457870131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2017029220
- Practice address
- 2133 Vadalabene Dr
Maryville, IL 62062-5839 - Phone
- (618) 391-6714
- NPI assigned
- Sep 14, 2017
- Last updated
- Jul 21, 2022
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2017029220 | MO | Primary |
Addresses
Primary practice location
2133 Vadalabene Dr
Maryville, IL 62062-5839
Mailing address
2133 Vadalabene Dr
Maryville, IL 62062-5839
Phone (618) 391-6714
Other practice location 1
15825 Manchester Rd Ste 209
Ellisville, MO 63011-2263
Phone (636) 391-9622
Other practice location 2
1034 S Brentwood Blvd Ste 725
Saint Louis, MO 63117-1271
Phone (636) 391-9622
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hearing Health Care, Inc. | Audiologist | 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, 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": "1505347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1457870131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2133 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625839",
"telephone_number": "618-391-6714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2133 VADALABENE DR",
"city": "MARYVILLE",
"state": "IL",
"postal_code": "620625839",
"telephone_number": "618-391-6714"
}
],
"practiceLocations": [
{
"address_1": "15825 Manchester Rd Ste 209",
"address_purpose": "LOCATION",
"city": "Ellisville",
"state": "MO",
"postal_code": "630112263",
"country_code": "US",
"telephone_number": "636-391-9622",
"fax_number": "636-391-9236",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1034 S Brentwood Blvd Ste 725",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631171271",
"country_code": "US",
"telephone_number": "636-391-9622",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAZIL",
"first_name": "TAYLER",
"middle_name": "RAE",
"name_prefix": "Dr.",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-09-14",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "2017029220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maryville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.