Active NPI
Terry Mongrain, HIS
- Audiologist-Hearing Aid Fitter
- East Wenatchee, WA
National Provider Identifier
1669071510
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- HA61034979
- Practice address
- 612 Valley Mall Pkwy
East Wenatchee, WA 98802-4838 - Phone
- (509) 888-3277
- Fax
- (509) 888-4327
- NPI assigned
- Oct 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | HA61034979 | WA | Primary |
Addresses
Primary practice location
612 Valley Mall Pkwy
East Wenatchee, WA 98802-4838
Mailing address
612 Valley Mall Pkwy
East Wenatchee, WA 98802-4838
Phone (509) 888-3277
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HA61034979 | Other | WA | HEARING AID SPECIALIST LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hometownhearing@nwi.net | Other |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HA61034979 | WA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Sound Hearing, LLC | Current | Accepting new patients | |
| Hometown Hearing PLLC | Past | Accepting new patients |
Locations
612 Valley Mall Pkwy
East Wenatchee, WA 98802
Phone (509) 888-3277
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 and National Provider Directory roles.
-
- Hearing Instrument Specialist
- East Wenatchee, WA
- NPI 1215643879
-
- Hearing Aid Equipment
- East Wenatchee, WA
- NPI 1386171122
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1669071510",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "612 VALLEY MALL PKWY",
"city": "EAST WENATCHEE",
"state": "WA",
"postal_code": "988024838",
"telephone_number": "509-888-3277",
"fax_number": "509-888-4327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "612 VALLEY MALL PKWY",
"city": "EAST WENATCHEE",
"state": "WA",
"postal_code": "988024838",
"telephone_number": "509-888-3277",
"fax_number": "509-888-4327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MONGRAIN",
"first_name": "TERRY",
"name_prefix": "Mr.",
"credential": "HIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-10-21",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "WA",
"license": "HA61034979",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEARING AID SPECIALIST LICENSE",
"identifier": "HA61034979",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hometownhearing@nwi.net",
"affiliation": "N",
"endpointDescription": "email address",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "email",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "612 Valley Mall Pkwy",
"city": "East Wenatchee",
"state": "WA",
"country_code": "US",
"postal_code": "988024838",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in East Wenatchee, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.