Active NPI
Katherine Mackenzie Fick, AUD
- Audiologist
- Ann Arbor, MI
National Provider Identifier
1710125182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601001135
- Practice address
- 1500 E Medical Center Dr
Ann Arbor, MI 48109-5000 - Phone
- (734) 936-4000
- NPI assigned
- Jan 23, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 0501 | KY | |
| Audiologist-Hearing Aid Fitter | 237600000X | 0980 | KY | |
| Audiologist | 231H00000X | 1601001135 | MI | Primary |
Addresses
Primary practice location
1500 E Medical Center Dr
Ann Arbor, MI 48109-5000
Mailing address
3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299
Other practice location 1
401 E Chestnut St
Suite 710
Louisville, KY 40202-5700
Phone (502) 583-8303
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50023223 | Other | KY | PASSPORT |
| 1710125182 | Other | KY | PASSPORT ADVANTAGE |
| 200941130 | Medicaid | IN |
Other names 1
- Katherine M Speaker
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0980 | KY | MD | Clinical Psychologist |
| 0501 | KY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Surgical Associates, PSC | Audiologist | Past | Accepting new patients |
Organizations & group practices 1
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": "1232668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711584000000",
"number": "1710125182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3621 S STATE ST",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081633",
"telephone_number": "734-647-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 E MEDICAL CENTER DR",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481095000",
"telephone_number": "734-936-4000"
}
],
"practiceLocations": [
{
"address_1": "401 E Chestnut St",
"address_2": "Suite 710",
"address_purpose": "LOCATION",
"city": "Louisville",
"state": "KY",
"postal_code": "402025700",
"country_code": "US",
"telephone_number": "502-583-8303",
"fax_number": "502-584-0302",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FICK",
"first_name": "KATHERINE",
"middle_name": "MACKENZIE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-23",
"last_updated": "2024-03-28",
"certification_date": "2024-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "KY",
"license": "0501",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "KY",
"license": "0980",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601001135",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT",
"identifier": "50023223",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PASSPORT ADVANTAGE",
"identifier": "1710125182",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200941130",
"state": "IN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KATHERINE",
"last_name": "SPEAKER",
"middle_name": "M",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.