Organization Active NPI

Grosse Pointe Audiology, LLC

  • Audiologist
  • Grosse Pointe Woods, MI
National Provider Identifier
1902928864
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Legal business name
GROSSE POINTE AUDIOLOGY, LLC
Practice address
20239 Mack Avenue
Grosse Pointe Audiology
Grosse Pointe Woods, MI 48236-1769
Phone
(313) 343-5555
Fax
(313) 343-5304
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Authorized official

Name
Dr. Ginette Alicia Lezotte, AU.D., CCC-ANPI 1124063615
Title
Audiologist/Owner
Phone
(313) 343-5555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X Primary
Hearing Aid Equipment 332S00000X

Addresses

Primary practice location

20239 Mack Avenue
Grosse Pointe Audiology
Grosse Pointe Woods, MI 48236-1769

Mailing address

20239 Mack Avenue
Grosse Pointe Audiology
Grosse Pointe Woods, MI 48236-1769
Phone (313) 343-5555

Other identifiers 2

IdentifierTypeStateIssuer
804683505MedicaidMI
904396202MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070725000335 MI Part B Supplier - Clinic/Group Practice 8628179322 Receives reassigned benefits from 3 practitioners
Practice locations: Grosse Pointe Woods, MI

National Provider Directory

National Provider Directory

Locations

20239 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 343-5555

19794 Mack Ave
Grosse Pointe Woods, MI 48236
Phone (313) 343-5555

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303689600000",
    "number": "1902928864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20239 MACK AVENUE",
            "address_2": "GROSSE POINTE AUDIOLOGY",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361769",
            "telephone_number": "313-343-5555",
            "fax_number": "313-343-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20239 MACK AVENUE",
            "address_2": "GROSSE POINTE AUDIOLOGY",
            "city": "GROSSE POINTE WOODS",
            "state": "MI",
            "postal_code": "482361769",
            "telephone_number": "313-343-5555",
            "fax_number": "313-343-5304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSSE POINTE AUDIOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2011-04-25",
        "status": "A",
        "authorized_official_last_name": "LEZOTTE",
        "authorized_official_first_name": "GINETTE",
        "authorized_official_middle_name": "ALICIA",
        "authorized_official_title_or_position": "AUDIOLOGIST/OWNER",
        "authorized_official_telephone_number": "313-343-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D., CCC-A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332S00000X",
            "taxonomy_group": "",
            "desc": "Hearing Aid Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804683505",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "904396202",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Woods, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.