Active NPI
Fairwood Hearing Care, PLLP
- Audiologist
- Renton, WA
National Provider Identifier
1528645975
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114974177 | Medicaid | WA |
Other names 1
- Fairwood Hearing Care
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | david@fairwoodhearingcare.com | Direct |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Audiologist
- Bellevue, WA
- NPI 1114974177
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.