Individual provider Active NPI

Kassondra Grace Hemmen, AU.D.

  • Audiologist
  • Port Orange, FL
National Provider Identifier
1154970960
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2310 Issued in FL
Practice address
3840 S Nova Rd Ste B1
Port Orange, FL 32127-4244
Phone
(386) 756-8225
Fax
(386) 767-0742
NPI assigned
Sep 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X AY2310 FL
Audiologist 231H00000X AY2310 FL Primary

Addresses

Primary practice location

3840 S Nova Rd Ste B1
Port Orange, FL 32127-4244

Mailing address

3840 S Nova Rd Ste B1
Port Orange, FL 32127-4244
Phone (386) 756-8225

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200505001105 FL Practitioner - Qualified Audiologist 7719318815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1400 Hand Ave
Suite M
Ormond Beach, FL 32174-8196
Phone (386) 673-5280

1680 Dunlawton Ave
Port Orange, FL 32127-4754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2310FLMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Audiology, LLC Audiologist CurrentSince Dec 31, 2020 Accepting new patients
Deborah R. Zarajczyk, Ma and Associates, PA Audiologist-Hearing Aid Fitter Past Accepting new patients
Audiology Distribution, LLC Audiologist-Hearing Aid Fitter PastSince Mar 1, 2019 Accepting new patients

Locations

263 N Causeway
New Smyrna Beach, FL 32169
Phone (386) 258-7100

742 N Volusia Ave
Orange City, FL 32763
Phone (386) 561-9496

1400 Hand Ave
Ste M
Ormond Beach, FL 32174
Phone (386) 673-5280

279 Forest Park Cir
Panama City, FL 32405
Phone (850) 481-8056

3840 S Nova Rd
Ste B1
Port Orange, FL 32127
Phone (386) 756-8225

1680 Dunlawton Ave
Port Orange, FL 32127
Phone (386) 304-1212

1690 US Highway 1 S
Ste B
Saint Augustine, FL 32084
Phone (386) 585-4161

2690 S Hopkins Ave
Ste 2
Titusville, FL 32780
Phone (321) 255-8700

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": "1567641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1154970960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3840 S NOVA RD STE B1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274244",
            "telephone_number": "386-756-8225",
            "fax_number": "386-767-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 S NOVA RD STE B1",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274244",
            "telephone_number": "386-756-8225",
            "fax_number": "386-767-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEMMEN",
        "first_name": "KASSONDRA",
        "middle_name": "GRACE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-05",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "FL",
            "license": "AY2310",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.