Individual provider Active NPI

Marie Neel Walser

  • Audiologist
  • Champaign, IL
National Provider Identifier
1558717140
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
147001742 Issued in IL
Practice address
3105 Fields South Dr
Champaign, IL 61822-3743
Phone
(217) 902-3277
NPI assigned
May 12, 2016
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X NU
Audiologist 231H00000X 147001742 IL Primary

Addresses

Primary practice location

3105 Fields South Dr
Champaign, IL 61822-3743

Mailing address

611 W. Park St.
Fapc
Urbana, IL 61801

Other practice location 1

103 Canal Landing Blvd Ste 3
Rochester, NY 14626-5108
Phone (585) 723-3440

Other practice location 2

241 Freedom Way
Midway Park, NC 28544-1418
Phone (910) 938-3099

Other names 1

  • Marie Neel Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171010002679 NC Practitioner - Qualified Audiologist 7113292533 Reassigns benefits to 1 organization
I20200206001312 IL Practitioner - Qualified Audiologist 7113292533 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12612NCMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Physicians Current Accepting new patients
Carle Health Medical Group CurrentSince Jan 6, 2020 Accepting new patients
Carolinaeast Physicians CurrentSince Aug 7, 2017 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Nov 1, 2025 Accepting new patients
Carolinaeast Physicians CurrentSince Aug 7, 2017 Accepting new patients
Richland Memorial Hospital, Inc CurrentSince Nov 1, 2025 Accepting new patients
Clear Choice Hearing Solutions, Inc Audiologist Past Accepting new patients

Locations

3105 Fields South Dr
Champaign, IL 61822
Phone (217) 902-3277

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

532 Webb Blvd
Havelock, NC 28532
Phone (252) 447-7088

241 Freedom Way
Midway Park, NC 28544
Phone (910) 938-3099

137 Medical Ln
Pollocksville, NC 28573
Phone (252) 633-1010

Organizations & group practices 7

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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1558717140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W. PARK ST.",
            "address_2": "FAPC",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "61801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 FIELDS SOUTH DR",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618223743",
            "telephone_number": "217-902-3277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Canal Landing Blvd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146265108",
            "country_code": "US",
            "telephone_number": "585-723-3440",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "241 Freedom Way",
            "address_purpose": "LOCATION",
            "city": "Midway Park",
            "state": "NC",
            "postal_code": "285441418",
            "country_code": "US",
            "telephone_number": "910-938-3099",
            "fax_number": "910-938-3243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALSER",
        "first_name": "MARIE",
        "middle_name": "NEEL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147001742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIE",
            "last_name": "NEEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.