Organization Active NPI

Audicare Hearing Centers Inc.

  • Audiologist-Hearing Aid Fitter
  • Traverse City, MI
National Provider Identifier
1932144425
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
Legal business name
AUDICARE HEARING CENTERS INC.
Practice address
4620 US 31 N
Traverse City, MI 49686-3757
Phone
(231) 238-3111
Fax
(231) 238-3218
NPI assigned
Jun 18, 2006
Last updated
Jul 10, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Marlene A Bevan, PHDNPI 1679518153
Title
Owner
Phone
(231) 238-3111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X Primary

Addresses

Primary practice location

4620 US 31 N
Traverse City, MI 49686-3757

Mailing address

4620 US 31 N
Traverse City, MI 49686-3757
Phone (231) 238-3111

Other identifiers 8

IdentifierTypeStateIssuer
804707465MedicaidMI
903380558MedicaidMI
540B802900OtherMABLUE CROSS BLUE SHIELD
640B827240OtherMIBLUE CROSS BLUE SHIELD
804707456MedicaidMI
902575198MedicaidMI
904073810MedicaidMI
804707447MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061025000629 MI Part B Supplier - Clinic/Group Practice 1658378153 Receives reassigned benefits from 2 practitioners
Practice locations: Gaylord, MI; Traverse City, MI

National Provider Directory

National Provider Directory

Locations

145 M 66 N
Charlevoix, MI 49720
Phone (231) 547-3100

829 W Main St
Ste C1
Gaylord, MI 49735
Phone (989) 705-2100

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1932144425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4620 US 31 N",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863757",
            "telephone_number": "231-238-3111",
            "fax_number": "231-238-3218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4620 US 31 N",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863757",
            "telephone_number": "231-238-3111",
            "fax_number": "231-238-3218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUDICARE HEARING CENTERS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "BEVAN",
        "authorized_official_first_name": "MARLENE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-238-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804707465",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "903380558",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "540B802900",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "640B827240",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804707456",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "902575198",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "904073810",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804707447",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; 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.