NPIMap

Individual provider Active NPI

Mary Therese Everett, MA

  • Audiologist
  • Fort Wayne, IN
National Provider Identifier
1528217064
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002170A Issued in IN
Practice address
9131 Lima Rd
Fort Wayne, IN 46818-1803
Phone
(260) 489-2693
Fax
(260) 489-1495
NPI assigned
Sep 9, 2008
Last updated
Sep 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002170A IN Primary
Assistive Technology Practitioner Audiologist 231HA2400X 23002170A IN
Audiologist-Hearing Aid Fitter 237600000X 23002170A IN

Addresses

Primary practice location

9131 Lima Rd
Fort Wayne, IN 46818-1803

Mailing address

9131 Lima Rd
Fort Wayne, IN 46818-1803
Phone (260) 489-2693

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
23002170AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Physicians Inc Past Accepting new patients
Fort Wayne Hearing Center & Audiology, Inc. Audiologist Past Accepting new patients
Allied Physicians Inc Audiologist Past Accepting new patients

Organizations & group practices 3

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": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1528217064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 LIMA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181803",
            "telephone_number": "260-489-2693",
            "fax_number": "260-489-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 LIMA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468181803",
            "telephone_number": "260-489-2693",
            "fax_number": "260-489-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "MARY",
        "middle_name": "THERESE",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002170A",
            "primary": true
        },
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "IN",
            "license": "23002170A",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IN",
            "license": "23002170A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; 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.