Individual provider Active NPI

Lindsey Rebecca Moder, AU.D

  • Audiologist
  • Lakeland, FL
National Provider Identifier
1043827181
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2396 Issued in FL
Practice address
1755 N Florida Ave
Lakeland, FL 33805-3109
Phone
(863) 680-7486
Fax
(866) 264-8519
NPI assigned
Sep 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2396 FL Primary

Addresses

Primary practice location

1755 N Florida Ave
Lakeland, FL 33805-3109

Mailing address

1600 Lakeland Hills Blvd
Lakeland, FL 33805-3019
Phone (863) 680-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220405001142 TX Practitioner - Qualified Audiologist 3375962673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2396FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Metx, LLC CurrentSince Oct 29, 2023 Accepting new patients
Allison Audiology & Hearing Aid Services, P.C. Audiologist CurrentSince Feb 4, 2022 Accepting new patients
Allison Audiology & Hearing Aid Center PC Audiologist CurrentSince Feb 4, 2022 Accepting new patients

Locations

12900 Queensbury Ln
Ste 100
Houston, TX 77079
Phone (713) 322-6974

104 Circle Way St
Ste D
Lake Jackson, TX 77566
Phone (979) 292-8501

Organizations & group practices 3

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633910400000",
    "number": "1043827181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 LAKELAND HILLS BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053019",
            "telephone_number": "863-680-7000",
            "fax_number": "866-264-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1755 N FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053109",
            "telephone_number": "863-680-7486",
            "fax_number": "866-264-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODER",
        "first_name": "LINDSEY",
        "middle_name": "REBECCA",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.