Organization Active NPI

Fairwood Hearing Care, PLLP

  • Audiologist
  • Renton, WA
National Provider Identifier
1528645975
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
FAIRWOOD HEARING CARE, PLLP
Practice address
16721 SE 162ND St
Renton, WA 98058-4229
Phone
(206) 200-4455
Fax
(844) 791-6253
NPI assigned
Mar 24, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Authorized official

Name
David Rolla Renne
Title
Audiologist/Owner
Phone
(206) 200-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary

Addresses

Primary practice location

16721 SE 162ND St
Renton, WA 98058-4229

Mailing address

16721 SE 162ND St
Renton, WA 98058-4229
Phone (206) 200-4455

Other identifiers 1

IdentifierTypeStateIssuer
1114974177MedicaidWA

Other names 1

  • Fairwood Hearing Care Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address david@fairwoodhearingcare.com Direct

National Provider Directory

National Provider Directory

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": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616544000000",
    "number": "1528645975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16721 SE 162ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980584229",
            "telephone_number": "206-200-4455",
            "fax_number": "844-791-6253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16721 SE 162ND ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980584229",
            "telephone_number": "206-200-4455",
            "fax_number": "844-791-6253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRWOOD HEARING CARE, PLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "RENNE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "ROLLA",
        "authorized_official_title_or_position": "AUDIOLOGIST/OWNER",
        "authorized_official_telephone_number": "206-200-4455"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114974177",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "david@fairwoodhearingcare.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "16721 SE 162nd St",
            "city": "Renton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980584229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Fairwood Hearing Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2021; 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.