Individual provider Active NPI

Maryann Heider, MED CCCA

  • Audiologist
  • Centerville, OH
National Provider Identifier
1588780480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A00547 Issued in OH
Practice address
255 N Main St
Centerville, OH 45459
Phone
(937) 435-7476
Fax
(937) 435-6666
NPI assigned
Mar 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A00547 OH Primary

Addresses

Primary practice location

255 N Main St
Centerville, OH 45459

Mailing address

255 N Main St
Centerville, OH 45459
Phone (937) 435-7476

Other identifiers 1

IdentifierTypeStateIssuer
000000321651OtherANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160329001958 MA Practitioner - Qualified Audiologist 7618042490

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

300 Crown Colony Dr
Suite 201
Quincy, MA 02169-0904

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
1084MAMDAthletic Trainer
A00547OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Eye and Ear Infirmary Current Accepting new patients
Southwest Ohio ENT Specialists Inc Past Accepting new patients

Locations

243 Charles St
Boston, MA 02114
Phone (617) 523-7900

Interoperability endpoints

  • Direct secure messaging: heider.maryann.meei@direct.partners.masshiway.net
  • FHIR API: https://fhir4.healow.com/fhir/r4/HDIFCD

Organizations & group practices 2

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": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588780480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 N MAIN ST",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-435-7476",
            "fax_number": "937-435-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N MAIN ST",
            "city": "CENTERVILLE",
            "state": "OH",
            "postal_code": "45459",
            "telephone_number": "937-435-7476",
            "fax_number": "937-435-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDER",
        "first_name": "MARYANN",
        "credential": "MED CCCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A00547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000321651",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Centerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.