Individual provider Active NPI

Nicole Maynard, AU.D.

  • Audiologist
  • Lebanon, NH
National Provider Identifier
1578946364
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A661 Issued in NH
Practice address
1 Medical Center Dr
DHMC Department of Audiology Dept. 4F
Lebanon, NH 03756-1000
Phone
(603) 650-8123
Fax
(603) 650-0052
NPI assigned
Jun 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A661 NH Primary

Addresses

Primary practice location

1 Medical Center Dr
DHMC Department of Audiology Dept. 4F
Lebanon, NH 03756-1000

Mailing address

1 Medical Center Dr
DHMC Department of Audiology Dept. 4F
Lebanon, NH 03756-1000
Phone (603) 650-8123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150904000349 NH Practitioner - Qualified Audiologist 3375859481 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnson Audiology LLCGroup PAC ID 5092932871, 4 clinicians

Practice addresses (Care Compare)

3855 Dartmouth College Hwy
North Haverhill, NH 03774-4937
Phone (603) 787-6971

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A661NHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Jul 28, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 28, 2015 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jul 28, 2015 Accepting new patients
Johnson Audiology LLC Audiologist CurrentSince Aug 29, 2023 Accepting new patients

Locations

2 Dorrance Pl
Hanover, NH 03755
Phone (603) 543-2020

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

3855 Dartmouth College Hwy
North Haverhill, NH 03774
Phone (603) 787-6971

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1578946364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF AUDIOLOGY DEPT. 4F",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8123",
            "fax_number": "603-650-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "address_2": "DHMC DEPARTMENT OF AUDIOLOGY DEPT. 4F",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-650-8123",
            "fax_number": "603-650-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYNARD",
        "first_name": "NICOLE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-30",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NH",
            "license": "A661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.