Individual provider Active NPI

Max R Mabry, CCC/FA

  • Audiologist
  • Bluefield, VA
National Provider Identifier
1730271834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201001323 Issued in VA
Practice address
1242 Hockman Pike
Bluefield, VA 24605-9351
Phone
(276) 326-3890
Fax
(276) 322-1514
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2201001323 VA Primary

Addresses

Primary practice location

1242 Hockman Pike
Bluefield, VA 24605-9351

Mailing address

208 Highland Ave
Princeton, WI 24740
Phone (304) 425-8058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000647 WV Practitioner - Qualified Audiologist 5698715365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2000
Medicare assignment
May accept Medicare assignment
Group practices
Greenbrier Audiology IncGroup PAC ID 8729216379, 6 clinicians

Practice addresses (Care Compare)

2216 S Kanawha St
Beckley, WV 25801-6720
Phone (304) 255-6310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Greenbrier Audiology, Inc. Audiologist CurrentSince Oct 29, 2024 Accepting new patients
Appalachian Hearing and Balance Audiologist Past Accepting new patients
Southeastern Ear, Nose & Throat Past Accepting new patients
Greenbrier Audiology and Hearing Aid Services, Inc. Audiologist PastSince Oct 29, 2024 Accepting new patients

Locations

2216 S Kanawha St
Beckley, WV 25801
Phone (304) 255-6310

1404 Robert C Byrd Dr
Ste 204
Crab Orchard, WV 25827

206 Dawkins Dr
Lewisburg, WV 24901
Phone (304) 647-4327

Organizations & group practices 4

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730271834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HIGHLAND AVE",
            "city": "PRINCETON",
            "state": "WI",
            "postal_code": "24740",
            "telephone_number": "304-425-8058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1242 HOCKMAN PIKE",
            "city": "BLUEFIELD",
            "state": "VA",
            "postal_code": "246059351",
            "telephone_number": "276-326-3890",
            "fax_number": "276-322-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MABRY",
        "first_name": "MAX",
        "middle_name": "R",
        "credential": "CCC/FA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bluefield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.