Individual provider Active NPI

Brian Tanner Nelson, HIS

  • Hearing Instrument Specialist
  • Leesburg, FL
National Provider Identifier
1245041516
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
AS5859 Issued in FL
Practice address
713 N 14TH St
Leesburg, FL 34748-4205
Phone
(352) 314-8805
Fax
(407) 650-3065
NPI assigned
Jan 16, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AS5859 FL Primary

Addresses

Primary practice location

713 N 14TH St
Leesburg, FL 34748-4205

Mailing address

713 N 14TH St
Leesburg, FL 34748-4205
Phone (352) 314-8805

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AS5859FLMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Services Company USA, LLC Hearing Instrument Specialist Past Accepting new patients
Rem Audiology Associates, P.C. Past Accepting new patients

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736985600000",
    "number": "1245041516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 N 14TH ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347484205",
            "telephone_number": "352-314-8805",
            "fax_number": "407-650-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 N 14TH ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347484205",
            "telephone_number": "352-314-8805",
            "fax_number": "407-650-3065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "middle_name": "TANNER",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-01-16",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS5859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

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