Active NPI
Glenn Clippard, M.A., CCC-A
- Audiologist
- Detroit, MI
National Provider Identifier
1912150392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601000301
- Practice address
- 22151 Moross Rd
Prof BLDG I, Suite 223
Detroit, MI 48236-2167 - Phone
- (313) 343-3153
- Fax
- (313) 343-4111
- NPI assigned
- Oct 29, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601000301 | MI | Primary |
Addresses
Primary practice location
22151 Moross Rd
Prof BLDG I, Suite 223
Detroit, MI 48236-2167
Mailing address
22151 Moross Rd
Prof BLDG I, Suite 223
Detroit, MI 48236-2167
Phone (313) 343-3153
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601000301 | MI | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1912150392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22151 MOROSS RD",
"address_2": "PROF BLDG I, SUITE 223",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362167",
"telephone_number": "313-343-3153",
"fax_number": "313-343-4111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22151 MOROSS RD",
"address_2": "PROF BLDG I, SUITE 223",
"city": "DETROIT",
"state": "MI",
"postal_code": "482362167",
"telephone_number": "313-343-3153",
"fax_number": "313-343-4111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLIPPARD",
"first_name": "GLENN",
"credential": "M.A., CCC-A",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-29",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601000301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.