Individual provider Active NPI

Molly R Hunter, AU.D.

  • Audiologist
  • Sterling Heights, MI
National Provider Identifier
1962722363
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000635 Issued in MI
Practice address
11080 Hall Rd Ste a
Sterling Heights, MI 48314-1511
Phone
(586) 254-0033
NPI assigned
Jun 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000635 MI Primary

Addresses

Primary practice location

11080 Hall Rd Ste a
Sterling Heights, MI 48314-1511

Mailing address

11080 Hall Rd Ste a
Sterling Heights, MI 48314-1511

Other identifiers 1

IdentifierTypeStateIssuer
700F399670OtherMIBCBSM GROUP PIN

Other names 1

  • Molly R Bergsbaken Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130322000157 MI Practitioner - Qualified Audiologist 4587858378 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8611MNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health St. John Hospital Current 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": "1275955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432080000000",
    "number": "1962722363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11080 HALL RD STE A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11080 HALL RD STE A",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483141511",
            "telephone_number": "586-254-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "MOLLY",
        "middle_name": "R",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-08",
        "last_updated": "2015-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "700F399670",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "BERGSBAKEN",
            "middle_name": "R",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.