NPIMap

Individual provider Active NPI

Jacqueline Krimm, BC-HIS

  • Hearing Instrument Specialist
  • Mount Laurel, NJ
National Provider Identifier
1770183170
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
25MG00137300 Issued in NJ
Practice address
3117 Route 38
Mount Laurel, NJ 08054-9752
Phone
(856) 273-9181
Fax
(856) 665-6813
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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 25MG00137300 NJ Primary

Addresses

Primary practice location

3117 Route 38
Mount Laurel, NJ 08054-9752

Mailing address

329 Marlton Pike W
Cherry Hill, NJ 08002
Phone (856) 471-7870

Other identifiers 1

IdentifierTypeStateIssuer
25MG00137300OtherNJHEARING AID DISPENSERS EXAMINING COMMITTEE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address AdminOffice@HearMiracleEar.com Direct

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
25MG00137300NJMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Mid Atlantic Hearing LLC PastSince Nov 1, 2020 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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1770183170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 MARLTON PIKE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-471-7870",
            "fax_number": "856-665-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3117 ROUTE 38",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549752",
            "telephone_number": "856-273-9181",
            "fax_number": "856-665-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIMM",
        "first_name": "JACQUELINE",
        "credential": "BC-HIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "NJ",
            "license": "25MG00137300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARING AID DISPENSERS EXAMINING COMMITTEE",
            "identifier": "25MG00137300",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AdminOffice@HearMiracleEar.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "329 MARLTON PIKE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "08002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; 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.