Active NPI
Marjorie Ann Gutierrez, HCP
- Hearing Instrument Specialist
- Plymouth, IN
National Provider Identifier
1891201034
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 17001319A
- Practice address
- 1407 N Michigan St
Plymouth, IN 46563-1119 - Phone
- (574) 941-2220
- Fax
- (574) 941-2227
- NPI assigned
- Dec 26, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 17001319A | IN | Primary |
Addresses
Primary practice location
1407 N Michigan St
Plymouth, IN 46563-1119
Mailing address
1407 N Michigan St
Plymouth, IN 46563-1119
Phone (574) 941-2220
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 17001319A | Other | IN | INDIANA STATE LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 17001319A | IN | MD | Hearing Instrument Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1514246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1891201034",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1407 N MICHIGAN ST",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465631119",
"telephone_number": "574-941-2220",
"fax_number": "574-941-2227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1407 N MICHIGAN ST",
"city": "PLYMOUTH",
"state": "IN",
"postal_code": "465631119",
"telephone_number": "574-941-2220",
"fax_number": "574-941-2227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUTIERREZ",
"first_name": "MARJORIE",
"middle_name": "ANN",
"credential": "HCP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-12-26",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "IN",
"license": "17001319A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA STATE LICENSE",
"identifier": "17001319A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.