NPIMap

Organization Active NPI

Hearing Wellness Center

  • Audiologist
  • Duluth, MN
National Provider Identifier
1649530361
Registry record updated May 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
6443 Issued in MN
Legal business name
HEARING WELLNESS CENTER
Practice address
1525 London Rd
Duluth, MN 55812-1617
Phone
(218) 623-1045
Fax
(218) 724-1096
NPI assigned
May 29, 2012
Last updated
May 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2020

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

Authorized official

Name
Dr. Jonathan P Gervais, AU.D.NPI 1427093475
Title
Audiologist
Phone
(218) 623-1045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X 6443 MN Primary
Audiologist-Hearing Aid FitterGroup: 193200000X MULTI-SPECIALTY GROUP 237600000X

Addresses

Primary practice location

1525 London Rd
Duluth, MN 55812-1617

Mailing address

1525 London Rd
Duluth, MN 55812-1617
Phone (218) 623-1045

Other practice location 1

677 Anne St NW Ste G
Bemidji, MN 56601-4391
Phone (218) 333-8833

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121018000812 MN Part B Supplier - Clinic/Group Practice 8820248370 Receives reassigned benefits from 5 practitioners
Practice locations: Bemidji, MN; Duluth, MN; Hermantown, MN

National Provider Directory

National Provider Directory

Locations

1420 London Rd
Ste 105
Duluth, MN 55805
Phone (218) 623-1045

4163 Haines Rd
Hermantown, MN 55811
Phone (218) 623-6670

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589846400000",
    "number": "1649530361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121617",
            "telephone_number": "218-623-1045",
            "fax_number": "218-724-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558121617",
            "telephone_number": "218-623-1045",
            "fax_number": "218-724-1096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Anne St NW Ste G",
            "address_purpose": "LOCATION",
            "city": "Bemidji",
            "state": "MN",
            "postal_code": "566014391",
            "country_code": "US",
            "telephone_number": "218-333-8833",
            "fax_number": "218-333-8375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEARING WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2020-05-19",
        "certification_date": "2020-05-19",
        "status": "A",
        "authorized_official_last_name": "GERVAIS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "218-623-1045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "MN",
            "license": "6443",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.