Individual provider Active NPI

Mary Miller, PHD, CCC-A

  • Audiologist
  • Hammond, LA
National Provider Identifier
1871528596
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5622 Issued in LA
Practice address
16038 Doctors Blvd
Hammond, LA 70403-1478
Phone
(985) 419-8080
Fax
(985) 542-0282
NPI assigned
Jul 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Assistive Technology Practitioner Audiologist 231HA2400X 5622 LA
Assistive Technology Supplier Audiologist 231HA2500X 5622 LA
Audiologist-Hearing Aid Fitter 237600000X 5622 LA
Audiologist 231H00000X 5622 LA Primary

Addresses

Primary practice location

16038 Doctors Blvd
Hammond, LA 70403-1478

Mailing address

16038 Doctors Blvd
Hammond, LA 70403-1478
Phone (985) 419-8080

Other practice location 1

1327 W Causeway Approach
Mandeville, LA 70471-3043
Phone (985) 419-8080

Other identifiers 1

IdentifierTypeStateIssuer
1169471MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000486 LA Practitioner - Qualified Audiologist 7517964430 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Hearing and Balance, LLCGroup PAC ID 4789829565, 4 clinicians

Practice addresses (Care Compare)

16038 Doctors Blvd
Hammond, LA 70403-1478
Phone (985) 419-8080

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5622LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Hearing and Balance, LLC Audiologist CurrentSince Nov 6, 2012 Accepting new patients

Locations

16038 Doctors Blvd
Hammond, LA 70403
Phone (985) 327-5905

1327 W Causeway Approach
Mandeville, LA 70471
Phone (985) 419-8080

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": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1871528596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16038 DOCTORS BLVD",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031478",
            "telephone_number": "985-419-8080",
            "fax_number": "985-542-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16038 DOCTORS BLVD",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031478",
            "telephone_number": "985-419-8080",
            "fax_number": "985-542-0282"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1327 W Causeway Approach",
            "address_purpose": "LOCATION",
            "city": "Mandeville",
            "state": "LA",
            "postal_code": "704713043",
            "country_code": "US",
            "telephone_number": "985-419-8080",
            "fax_number": "985-542-0282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "PHD, CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231HA2400X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Practitioner",
            "state": "LA",
            "license": "5622",
            "primary": false
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "LA",
            "license": "5622",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "LA",
            "license": "5622",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "LA",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1169471",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.