Individual provider Active NPI

Kirsten Thomas Atwood, AU.D, ,CCC-A

  • Audiologist
  • Fort Pierce, FL
National Provider Identifier
1104098052
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1177 Issued in FL
Practice address
4632 S 25TH St
Fort Pierce, FL 34981-5057
Phone
(772) 464-9595
Fax
(772) 464-9582
NPI assigned
Apr 1, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1177 FL Primary

Addresses

Primary practice location

4632 S 25TH St
Fort Pierce, FL 34981-5057

Mailing address

4632 S 25TH St
Fort Pierce, FL 34981-5057
Phone (772) 464-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090203000660 FL Practitioner - Qualified Audiologist 0446314652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independence Ear, Nose and Throat LLC 9 clinicians

Practice addresses (Care Compare)

1400 NW Federal Hwy
Stuart, FL 34994-1020
Phone (772) 888-1880

Merit-based Incentive Payment System (MIPS)

Final score
84.38 of 100Reported as group
Quality
81.3
Improvement activities
40
Cost
72.85

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1177FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Jun 1, 2023 Accepting new patients
Independence Ear, Nose & Throat, LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

4632 S 25th St
Fort Pierce, FL 34981
Phone (772) 464-9595

2221 SE Ocean Blvd
Ste 300
Stuart, FL 34996
Phone (772) 220-8459

931 SE Ocean Blvd
Ste A
Stuart, FL 34994
Phone (772) 283-3820

1400 NW US 1
Stuart, FL 34994
Phone (772) 888-1880

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEFDCD

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": "1207008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1104098052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-464-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4632 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349815057",
            "telephone_number": "772-464-9595",
            "fax_number": "772-464-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWOOD",
        "first_name": "KIRSTEN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "AU.D, ,CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-01",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.