Organization Active NPI

Lawrence Clayton & Associates, LLC

Doing business as Hearing Healthcare of Illinois

  • Audiologist-Hearing Aid Fitter
  • Rockford, IL
National Provider Identifier
1659552701
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
147-000198 Issued in IL
Legal business name
LAWRENCE CLAYTON & ASSOCIATES, LLC
Doing business as
Hearing Healthcare of Illinois
Practice address
435 N Mulford Rd Ste 10
Rockford, IL 61107-5100
Phone
(815) 399-5279
Fax
(815) 399-3764
NPI assigned
Nov 16, 2007
Last updated
May 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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

Authorized official

Name
Mrs. Leigh Ann Tackaberry, AUDNPI 1316053523
Title
Clinical Audiologist
Phone
(815) 399-5279

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 147-000198 IL Primary

Addresses

Primary practice location

435 N Mulford Rd Ste 10
Rockford, IL 61107-5100

Mailing address

435 N Mulford Rd Ste 10
Rockford, IL 61107-5100
Phone (815) 399-5279

Other names 1

  • Hearing Healthcare of Illinois Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050913001266 IL Part B Supplier - Clinic/Group Practice 1557394236 Receives reassigned benefits from 3 practitioners
Practice locations: Belvidere, IL; Lake Barrington, IL; Rockford, IL

National Provider Directory

National Provider Directory

Locations

205 Cadillac Ct
Ste 2
Belvidere, IL 61008
Phone (815) 399-5279

435 N Mulford Rd
#O
Rockford, IL 61107
Phone (815) 399-5279

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1195171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368489600000",
    "number": "1659552701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 N MULFORD RD STE 10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075100",
            "telephone_number": "815-399-5279",
            "fax_number": "815-399-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 N MULFORD RD STE 10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075100",
            "telephone_number": "815-399-5279",
            "fax_number": "815-399-3764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE CLAYTON & ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-16",
        "last_updated": "2013-05-14",
        "status": "A",
        "authorized_official_last_name": "TACKABERRY",
        "authorized_official_first_name": "LEIGH ANN",
        "authorized_official_title_or_position": "CLINICAL AUDIOLOGIST",
        "authorized_official_telephone_number": "815-399-5279",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IL",
            "license": "147-000198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hearing Healthcare of Illinois",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2013; 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.