Active NPI
Dave Greenidge, H.I.S
- Hearing Instrument Specialist
- Benton Harbor, MI
National Provider Identifier
1548048978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 3502013236
- Practice address
- 1980 Pipestone Rd
Benton Harbor, MI 49022-2315 - Phone
- (989) 244-7406
- NPI assigned
- Sep 18, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 17001623A | IN | |
| Hearing Instrument Specialist | 237700000X | 3502013236 | MI | Primary |
Addresses
Primary practice location
1980 Pipestone Rd
Benton Harbor, MI 49022-2315
Mailing address
1980 Pipestone Rd
Benton Harbor, MI 49022-2315
Phone (989) 244-7406
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17001623A | IN | MD | Hearing Instrument Specialist |
| 3502013236 | MI | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703548800000",
"number": "1548048978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1980 PIPESTONE RD",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222315",
"telephone_number": "989-244-7406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 PIPESTONE RD",
"city": "BENTON HARBOR",
"state": "MI",
"postal_code": "490222315",
"telephone_number": "989-244-7406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENIDGE",
"first_name": "DAVE",
"credential": "H.I.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-18",
"last_updated": "2023-12-26",
"certification_date": "2023-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IN",
"license": "17001623A",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MI",
"license": "3502013236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Benton Harbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.