Active NPI
Margaret Mary Gustafson, M.S.
- Audiologist
- Salem, OR
National Provider Identifier
1669520797
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 20725
- Practice address
- 2611 Pringle Rd SE
Salem, OR 97302-1533 - Phone
- (503) 588-5330
- Fax
- (503) 540-4473
- NPI assigned
- Jan 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 20725 | OR | Primary |
| Hearing Instrument Specialist | 237700000X | HAS-P-213786 | OR |
Addresses
Primary practice location
2611 Pringle Rd SE
Salem, OR 97302-1533
Mailing address
2611 Pringle Rd SE
Salem, OR 97302-1533
Phone (503) 588-5330
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 162826 | Medicaid | OR |
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20725 | OR | MD | Internal Medicine Physician |
| HAS-P-213786 | OR | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| MLM USA LLC | Audiologist | Past | Accepting new patients |
| Salem Audiology Clinic, Inc | Audiologist | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1669520797",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2611 PRINGLE RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973021533",
"telephone_number": "503-588-5330",
"fax_number": "503-540-4473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2611 PRINGLE RD SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973021533",
"telephone_number": "503-588-5330",
"fax_number": "503-540-4473"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUSTAFSON",
"first_name": "MARGARET",
"middle_name": "MARY",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-08",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OR",
"license": "20725",
"primary": true
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "OR",
"license": "HAS-P-213786",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "162826",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.