Provider Demographics
NPI:1316166473
Name:BATES, JAREN (AUD)
Entity type:Individual
Prefix:DR
First Name:JAREN
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-983-5350
Mailing Address - Fax:
Practice Address - Street 1:1908 HILCO ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-6387
Practice Address - Country:US
Practice Address - Phone:704-983-5350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7681231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC18789OtherBCBSNC
SCSAT012Medicaid
1487262OtherCOVENTRY
NCP01512639OtherRAILROAD MEDICARE
1487262OtherCOVENTRY