Integral Audiology PLLC

Primary specialty

AudiologistTaxonomy code 231H00000X

Legal business name

INTEGRAL AUDIOLOGY PLLC

Practice address

19485 Old Jetton Rd Ste 202
Cornelius, NC 28031-6582

Phone

(616) 826-4723

NPI assigned

Jan 29, 2025

Last updated

Jan 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eileen Clark, AUDNPI 1346806528

Title

Owner

Phone

(616) 826-4723

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Locations

Practitioners 1

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.

• Eileen Clark, AUD

  • Audiologist
  • Cornelius, NC
  • NPI 1346806528
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1738108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1932912326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD STE 202",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316582",
            "telephone_number": "616-826-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19485 OLD JETTON RD STE 202",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280316582",
            "telephone_number": "616-826-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRAL AUDIOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-29",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-826-4723",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Audiologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.