Joanna Rose Fennelly, AUD

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1601000465 Issued in MI

Practice address

2421 Monroe St Ste 202
Dearborn, MI 48124-3043

Phone

(313) 562-4485

NPI assigned

Jun 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1508068446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 SCOTT ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612133",
            "telephone_number": "248-321-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 MONROE ST STE 202",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481243043",
            "telephone_number": "313-562-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENNELLY",
        "first_name": "JOANNA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Audiologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.