1023020518 NPI number — MELISSA M. MOORE-SCHMITT M.A., CCC-A

Table of content: MELISSA M. MOORE-SCHMITT M.A., CCC-A (NPI 1023020518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023020518 NPI number — MELISSA M. MOORE-SCHMITT M.A., CCC-A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOORE-SCHMITT
Provider First Name:
MELISSA
Provider Middle Name:
M.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A., CCC-A
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023020518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ADVANCED HEARING SYSTEMS LLC
Provider Second Line Business Mailing Address:
4933 BENCHMARK CENTRE DRIVE, SUITE B
Provider Business Mailing Address City Name:
SWANSEA
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62226-8927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
618-628-1212
Provider Business Mailing Address Fax Number:
618-628-8520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ADVANCED HEARING SYSTEMS
Provider Second Line Business Practice Location Address:
4933 BENCHMARK CENTRE DRIVE, SUITE B
Provider Business Practice Location Address City Name:
SWANSEA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62226-8927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
618-628-1212
Provider Business Practice Location Address Fax Number:
618-628-8520
Provider Enumeration Date:
08/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2400X , with the licence number: 147-000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231HA2500X , with the licence number: 147-000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X , with the licence number: 147-000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237700000X , with the licence number: 147-000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X , with the licence number: 147000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 147-000155 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 338636371001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".