Individual provider Active NPI

Michele C Cannon, AUD

  • Audiologist
  • Alamogordo, NM
National Provider Identifier
1841523685
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4565 Issued in NM
Practice address
1401 10TH St Ste C
Alamogordo, NM 88310-5012
Phone
(575) 437-4327
Fax
(575) 437-5009
NPI assigned
Sep 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4565 NM Primary

Addresses

Primary practice location

1401 10TH St Ste C
Alamogordo, NM 88310-5012

Mailing address

1401 10TH St Ste C
Alamogordo, NM 88310-5012
Phone (575) 437-4327

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091111000092 NM Practitioner - Qualified Audiologist 1153469283 Reassigns benefits to 1 organization
Practice locations: Rio Rancho, NM

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology Distribution LLCGroup PAC ID 0840459103, 9 clinicians

Practice addresses (Care Compare)

3791 Southern Blvd SE
Suite 200
Rio Rancho, NM 87124-7413
Phone (505) 933-6315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4565NMMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Feb 23, 2025 Accepting new patients
National Sinus Institute PLLC Past Accepting new patients

Locations

555 Oppenheimer Dr
Ste 101
Los Alamos, NM 87544
Phone (505) 661-2405

3791 Southern Blvd SE
Rio Rancho, NM 87124
Phone (505) 933-6315

3791 Southern Blvd SE
Ste 200
Rio Rancho, NM 87124
Phone (505) 933-6315

1350 Paseo del Pueblo Sur
Ste 3
Taos, NM 87571
Phone (505) 751-9327

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HDAHAA

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": "1252627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300665600000",
    "number": "1841523685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 10TH ST STE C",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883105012",
            "telephone_number": "575-437-4327",
            "fax_number": "575-437-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 10TH ST STE C",
            "city": "ALAMOGORDO",
            "state": "NM",
            "postal_code": "883105012",
            "telephone_number": "575-437-4327",
            "fax_number": "575-437-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNON",
        "first_name": "MICHELE",
        "middle_name": "C",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-11",
        "last_updated": "2011-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NM",
            "license": "4565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alamogordo, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2011; 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.