Active NPI
Kathryn M Bazzett, AU.D.
- Audiologist
- Traverse City, MI
National Provider Identifier
1962806083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601000692
- Practice address
- 1126 S Garfield Ave
Traverse City, MI 49686 - Phone
- (231) 946-5451
- NPI assigned
- Oct 17, 2014
- Last updated
- Oct 8, 2019
- Sex
- Female
- 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 | 1601000692 | MI | Primary |
Addresses
Primary practice location
1126 S Garfield Ave
Traverse City, MI 49686
Mailing address
1126 S Garfield Ave
Traverse City, MI 49686-4352
Phone (231) 946-5451
Other practice location 1
21000 E 12 Mile Rd
Suite 111
Saint Clair Shores, MI 48081-1116
Phone (586) 779-7610
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 700F399670 | Other | MI | BCBSM GROUP PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Audiologist
- Midland, MI
- NPI 1477574705
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1413504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1570492800000",
"number": "1962806083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1126 S GARFIELD AVE",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "496864352",
"telephone_number": "231-946-5451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1126 S GARFIELD AVE",
"city": "TRAVERSE CITY",
"state": "MI",
"postal_code": "49686",
"telephone_number": "231-946-5451"
}
],
"practiceLocations": [
{
"address_1": "21000 E 12 Mile Rd",
"address_2": "Suite 111",
"address_purpose": "LOCATION",
"city": "Saint Clair Shores",
"state": "MI",
"postal_code": "480811116",
"country_code": "US",
"telephone_number": "586-779-7610",
"fax_number": "586-779-1391",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAZZETT",
"first_name": "KATHRYN",
"middle_name": "M",
"credential": "AU.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-10-17",
"last_updated": "2019-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601000692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM GROUP PIN",
"identifier": "700F399670",
"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 Oct 8, 2019; 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.