Individual provider Active NPI

Mary Ann Brockway, MA, CCC-A

  • Audiologist
  • North Andover, MA
National Provider Identifier
1861601338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
29 Issued in MA
Practice address
198 Massachusetts Ave
#103
North Andover, MA 01845-4143
Phone
(978) 685-7550
NPI assigned
May 22, 2007
Sex
Female
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 29 MA Primary

Addresses

Primary practice location

198 Massachusetts Ave
#103
North Andover, MA 01845-4143

Mailing address

198 Massachusetts Ave
#103
North Andover, MA 01845-4143
Phone (978) 685-7550

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)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Hearing Center LLC Audiologist PastSince Feb 7, 2021 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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861601338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MASSACHUSETTS AVE",
            "address_2": "#103",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454143",
            "telephone_number": "978-685-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MASSACHUSETTS AVE",
            "address_2": "#103",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454143",
            "telephone_number": "978-685-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCKWAY",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "MA, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "29",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.