Individual provider Active NPI

Michelle Lynn Borders, AUD.

  • Audiologist
  • Port Huron, MI
National Provider Identifier
1912197344
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000474 Issued in MI
Practice address
1522 Pine Grove Ave Ste a
Port Huron, MI 48060-3382
Phone
(810) 982-3277
Fax
(810) 982-0716
NPI assigned
Aug 1, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 1601000474 MI
Audiologist 231H00000X 1601000474 MI Primary

Addresses

Primary practice location

1522 Pine Grove Ave Ste a
Port Huron, MI 48060-3382

Mailing address

1522 Pine Grove Ave Ste a
Port Huron, MI 48060-3382
Phone (810) 982-3277

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617002020 MI Practitioner - Qualified Audiologist 8729400973

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Russell W. Craig DO, PC Past 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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1912197344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 PINE GROVE AVE STE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603382",
            "telephone_number": "810-982-3277",
            "fax_number": "810-982-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 PINE GROVE AVE STE A",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480603382",
            "telephone_number": "810-982-3277",
            "fax_number": "810-982-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDERS",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "AUD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000474",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.