Individual provider Active NPI

Brooke Mackenzie Knutson, AUD

  • Audiologist
  • Fort Myers, FL
National Provider Identifier
1235702218
Registry record updated Jul 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2486 Issued in FL
Practice address
9711 Commerce Center CT
Fort Myers, FL 33908-3817
Phone
(239) 939-2621
NPI assigned
Jul 19, 2021
Last updated
Jul 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 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 AY2486 FL Primary

Addresses

Primary practice location

9711 Commerce Center CT
Fort Myers, FL 33908-3817

Mailing address

1996 Parson St
Naples, FL 34120-5316
Phone (772) 584-9075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2486FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Associates MD PA CurrentSince Jul 20, 2021 Accepting new patients

Locations

9711 Commerce Center Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 939-2621

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626652800000",
    "number": "1235702218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1996 PARSON ST",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341205316",
            "telephone_number": "772-584-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 COMMERCE CENTER CT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083817",
            "telephone_number": "239-939-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "BROOKE",
        "middle_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.