Individual provider Active NPI

Cheryl J Marie, M.A.

  • Audiologist
  • Palatka, FL
National Provider Identifier
1174770911
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY969 Issued in FL
Practice address
320 Zeagler Dr Ste 1
Palatka, FL 32177-6854
Phone
(386) 325-1565
Fax
(386) 325-1571
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY969 FL Primary

Addresses

Primary practice location

320 Zeagler Dr Ste 1
Palatka, FL 32177-6854

Mailing address

320 Zeagler Dr Ste 1
Palatka, FL 32177-6854
Phone (386) 325-1565

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090622000360 FL Practitioner - Qualified Audiologist 3072664689 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent'S Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians

Practice addresses (Care Compare)

2035 Professional Ctr Dr a
Orange Park, FL 32073-4462
Phone (904) 272-3200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincents Ambulatory Care Inc CurrentSince Mar 24, 2016 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Mar 24, 2016 Accepting new patients

Locations

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

1658 St Vincents Way
Ste 200
Middleburg, FL 32068
Phone (904) 214-8100

2035 Professional Center Dr
Ste A
Orange Park, FL 32073
Phone (904) 272-3200

2035 Professional Center Dr
#Dj
Orange Park, FL 32073
Phone (904) 834-1002

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": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219363200000",
    "number": "1174770911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 ZEAGLER DR STE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776854",
            "telephone_number": "386-325-1565",
            "fax_number": "386-325-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 ZEAGLER DR STE 1",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776854",
            "telephone_number": "386-325-1565",
            "fax_number": "386-325-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARIE",
        "first_name": "CHERYL",
        "middle_name": "J",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2008-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palatka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.