Active NPI
Davenport Hearing Aid Center, Inc
- Audiologist
- Davenport, IA
National Provider Identifier
1477601680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 170
- Legal business name
- DAVENPORT HEARING AID CENTER, INC
- Practice address
- 430 W 35TH St
Davenport, IA 52806-5820 - Phone
- (563) 386-8885
- Fax
- (563) 386-5860
- NPI assigned
- Jan 7, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Micheal Charles Charles Hartman, AU.D.
- Title
- Owner Doctor of Audiology
- Phone
- (563) 386-8885
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 170 | IA | Primary |
Addresses
Primary practice location
430 W 35TH St
Davenport, IA 52806-5820
Mailing address
430 W 35TH St
Davenport, IA 52806-5820
Phone (563) 386-8885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0012799 | Medicaid | IA |
Other names 1
- Davenport Audiology Hearing Aid Center, Inc
National Provider Directory
National Provider DirectoryLocations
430 W 35th St
Stop 2
Davenport, IA 52806
Phone (563) 362-9529
541 E North St
Geneseo, IL 61254
Practitioners & affiliated clinicians
Practitioners 1
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": "1168128000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187049600000",
"number": "1477601680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 W 35TH ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528065820",
"telephone_number": "563-386-8885",
"fax_number": "563-386-5860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 W 35TH ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528065820",
"telephone_number": "563-386-8885",
"fax_number": "563-386-5860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVENPORT HEARING AID CENTER, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-07",
"last_updated": "2007-08-14",
"status": "A",
"authorized_official_last_name": "HARTMAN",
"authorized_official_first_name": "MICHEAL CHARLES",
"authorized_official_middle_name": "CHARLES",
"authorized_official_title_or_position": "OWNER DOCTOR OF AUDIOLOGY",
"authorized_official_telephone_number": "563-386-8885",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "AU.D."
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Audiologist",
"state": "IA",
"license": "170",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0012799",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Davenport Audiology Hearing Aid Center, Inc",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.