Individual provider Active NPI

Mary A Chatelain, AU.D.

  • Audiologist
  • Little Rock, AR
National Provider Identifier
1770764805
Registry record updated Feb 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A #307 Issued in AR
Practice address
10700 N. Rodney Parham Rd
Ste A7
Little Rock, AR 72212
Phone
(501) 225-6060
Fax
(501) 225-6450
NPI assigned
Nov 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A #307 AR Primary

Addresses

Primary practice location

10700 N. Rodney Parham Rd
Ste A7
Little Rock, AR 72212

Mailing address

10700 N. Rodney Parham Rd
Ste A7
Little Rock, AR 72212
Phone (501) 225-6060

Other identifiers 1

IdentifierTypeStateIssuer
A #307OtherARAU.D. LICENSE

Other names 1

  • Mary De Loach Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130404000254 AR Practitioner - Qualified Audiologist 5294970760 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pinnacle Hearing LLCGroup PAC ID 2062788557, 2 clinicians

Practice addresses (Care Compare)

10700 N Rodney Parham Rd
A7
Little Rock, AR 72212-4159
Phone (501) 225-6060

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A #307ARMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Hearing LLC CurrentSince Sep 16, 2017 Accepting new patients
Pinnacle Hearing LLC Audiologist Current Accepting new patients

Locations

675 California Ave SW
Camden, AR 71701
Phone (870) 836-6055

10700 N Rodney Parham Rd
Little Rock, AR 72212
Phone (501) 225-4648

10700 N Rodney Parham Rd
Ste A7
Little Rock, AR 72212
Phone (501) 225-6060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1770764805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10700 N. RODNEY PARHAM RD",
            "address_2": "STE A7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72212",
            "telephone_number": "501-225-6060",
            "fax_number": "501-225-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 N. RODNEY PARHAM RD",
            "address_2": "STE A7",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "72212",
            "telephone_number": "501-225-6060",
            "fax_number": "501-225-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHATELAIN",
        "first_name": "MARY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AR",
            "license": "A #307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AU.D. LICENSE",
            "identifier": "A #307",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DE LOACH",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Little Rock, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.