Stacy O'Brien Audiology

Primary specialty

AudiologistTaxonomy code 231H00000X

License

L14000162663 Issued in FL

Legal business name

STACY O'BRIEN AUDIOLOGY

Practice address

1185 Dunlawton Ave
Suite 103
Port Orange, FL 32127-2905

Phone

(813) 767-0938

NPI assigned

Jan 27, 2015

Last updated

Jan 27, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacy A O'Brien, AU.D.NPI 1730583360

Title

Owner/Operator

Phone

(813) 767-0938

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy A O'Brien, AU.D.

  • Audiologist
  • Port Orange, FL
  • NPI 1730583360
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422316800000",
    "number": "1093105280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4624 RIVERWALK VILLAGE CT",
            "city": "PONCE INLET",
            "state": "FL",
            "postal_code": "321277261",
            "telephone_number": "813-767-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1185 DUNLAWTON AVE",
            "address_2": "SUITE 103",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321272905",
            "telephone_number": "813-767-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY O'BRIEN AUDIOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2015-01-27",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "813-767-0938",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "L14000162663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Audiologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.