Carol Byrne, AU.D.
Individual provider Active NPI Audiologist · Jenison, MI
NPI 1508968157 · NPPES record last updated Apr 13, 2010
Key facts
- NPI
- 1508968157
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 1601000131 (MI)
- Practice address
- 8120 Amelia Dr
Jenison, MI 49428-9122 - Phone
- (616) 662-0647
- NPI assigned
- Sep 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120730000246 | MI | Practitioner - Qualified Audiologist | 5991961328 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601000131 | MI | Yes |
Addresses
Primary practice location
8120 Amelia Dr
Jenison, MI 49428-9122
Mailing address
8120 Amelia Dr
Jenison, MI 49428-9122
Other providers in Jenison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 13, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.