Individual provider Active NPI

Danielle Ann Northrup, AUD

  • Audiologist
  • Wyoming, MI
National Provider Identifier
1639783269
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000899 Issued in MI
Practice address
1555 44TH St SW
Wyoming, MI 49509-4313
Phone
(616) 249-8000
NPI assigned
Sep 1, 2020
Last updated
Sep 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000899 MI Primary

Addresses

Primary practice location

1555 44TH St SW
Wyoming, MI 49509-4313

Mailing address

129 S Drake Rd
Kalamazoo, MI 49009-1107
Phone (269) 271-4180

Other practice location 1

1425 Michigan St NE Ste A
Grand Rapids, MI 49503-2027
Phone (616) 459-4514

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200921001921 MI Practitioner - Qualified Audiologist 6608294897 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grand Rapids Ear Nose and Throat Center PLLCGroup PAC ID 0547332751, 10 clinicians

Practice addresses (Care Compare)

655 Kenmoor Ave SE a
Grand Rapids ENT Center PLLC
Grand Rapids, MI 49546-8622
Phone (616) 575-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1601000899MIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Grand Rapids Ear Nose & Throat Center PLLC CurrentSince Dec 6, 2023 Accepting new patients

Locations

2373 64th St SW
Ste 2300
Byron Center, MI 49315

655 Kenmoor Ave SE
Ste A
Grand Rapids, MI 49546
Phone (616) 575-1212

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": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1639783269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 S DRAKE RD",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091107",
            "telephone_number": "269-271-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 44TH ST SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495094313",
            "telephone_number": "616-249-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1425 Michigan St NE Ste A",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495032027",
            "country_code": "US",
            "telephone_number": "616-459-4514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NORTHRUP",
        "first_name": "DANIELLE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.