Individual provider Active NPI

Jennifer Madden Dauterman, M.A.

  • Audiologist
  • Michigan City, IN
National Provider Identifier
1750440434
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002404A Issued in IN
Practice address
1225 E Coolspring Ave Ste 300
Michigan City, IN 46360-6312
Phone
(219) 873-2992
Fax
(219) 878-5052
NPI assigned
Dec 8, 2006
Last updated
May 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 23002404A IN Primary

Addresses

Primary practice location

1225 E Coolspring Ave Ste 300
Michigan City, IN 46360-6312

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

1609 E 80th Ave
Merrillville, IN 46410-5737
Phone (219) 738-2730

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdauterman5719@Direct.FranciscanAlliance.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070831000010 IN Practitioner - Qualified Audiologist 4284727645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Physician NetworkGroup PAC ID 3072790682, 1,152 clinicians

Practice addresses (Care Compare)

1225 E Coolspring Ave
Suite 300
Michigan City, IN 46360-6312
Phone (219) 878-5031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
23002404AINMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients
Franciscan Physician Network CurrentSince Aug 1, 2011 Accepting new patients

Locations

35682 Eagle Way
Chicago, IL 60678

1704 Lafayette Rd
Ste 4
Crawfordsvlle, IN 47933
Phone (765) 364-3120

1040 Sierra Dr
Ste 400
Greenwood, IN 46143
Phone (317) 528-4886

1225 E Coolspring Ave
Michigan City, IN 46360
Phone (219) 873-2919

1225 E Coolspring Ave
Ste 300
Michigan City, IN 46360
Phone (219) 873-2992

150 W Washington St
Shelbyville, IN 46176
Phone (317) 392-3211

Interoperability endpoints

  • Direct secure messaging: jdauterman5719@direct.franciscanalliance.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1750440434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 E COOLSPRING AVE STE 300",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463606312",
            "telephone_number": "219-873-2992",
            "fax_number": "219-878-5052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1609 E 80th Ave",
            "address_purpose": "LOCATION",
            "city": "Merrillville",
            "state": "IN",
            "postal_code": "464105737",
            "country_code": "US",
            "telephone_number": "219-738-2730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAUTERMAN",
        "first_name": "JENNIFER",
        "middle_name": "MADDEN",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002404A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdauterman5719@Direct.FranciscanAlliance.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1225 E Coolspring Ave Ste 300",
            "city": "Michigan City",
            "state": "IN",
            "country_code": "US",
            "postal_code": "463606312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Michigan City, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.