Individual provider Active NPI

Michelle L Bumpers, AUD

  • Audiologist
  • Melbourne, FL
National Provider Identifier
1982475414
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2387 Issued in FL
Practice address
21 Suntree PL Ste 100
Melbourne, FL 32940-7600
Phone
(321) 254-5300
Fax
(321) 254-5301
NPI assigned
Jan 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2387 FL Primary

Addresses

Primary practice location

21 Suntree PL Ste 100
Melbourne, FL 32940-7600

Mailing address

21 Suntree PL Ste 100
Melbourne, FL 32940-7600
Phone (321) 254-5300

Other practice location 1

4780 Dairy Rd Ste 103
Melbourne, FL 32904-8482
Phone (321) 254-5300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240123002139 FL Practitioner - Qualified Audiologist 0941652242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2387FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Two Rivers Hearing Audiologist CurrentSince Jan 1, 2024 Accepting new patients
Fyz-Pinson CurrentSince Jan 1, 2024 Accepting new patients

Locations

21 Suntree Pl
Ste 100
Melbourne, FL 32940
Phone (321) 254-5300

4780 Dairy Rd
Ste 103
Melbourne, FL 32904
Phone (321) 254-5300

Organizations & group practices 2

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": "1705017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1982475414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 SUNTREE PL STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407600",
            "telephone_number": "321-254-5300",
            "fax_number": "321-254-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SUNTREE PL STE 100",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329407600",
            "telephone_number": "321-254-5300",
            "fax_number": "321-254-5301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4780 Dairy Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329048482",
            "country_code": "US",
            "telephone_number": "321-254-5300",
            "fax_number": "321-254-5301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUMPERS",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.