Individual provider Active NPI

Sally Ann Wesseldyk

  • Hearing Instrument Specialist
  • Holt, MI
National Provider Identifier
1720574809
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
3501004535 Issued in MA
Practice address
4706 Tolland Ave
Holt, MI 48842-1012
Phone
(517) 525-0892
NPI assigned
Jul 2, 2018
Last updated
Jul 2, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X 3501004535 MA Primary

Addresses

Primary practice location

4706 Tolland Ave
Holt, MI 48842-1012

Mailing address

4706 Tolland Ave
Holt, MI 48842-1012
Phone (517) 525-0892

Other names 1

  • Sally Ann Donnell Former name

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

LicenseStateTypeSpecialty
3501004535MAMDHearing Instrument Specialist

NPI Registry JSON

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

{
    "created_epoch": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1720574809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4706 TOLLAND AVE",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421012",
            "telephone_number": "517-525-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4706 TOLLAND AVE",
            "city": "HOLT",
            "state": "MI",
            "postal_code": "488421012",
            "telephone_number": "517-525-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESSELDYK",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MA",
            "license": "3501004535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "DONNELL",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Holt, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.