Individual provider Active NPI

Vicki Marie Connell, AU.D.

  • Audiologist
  • St Petersburg, FL
National Provider Identifier
1255536702
Registry record updated Mar 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY 744 Issued in FL
Practice address
620 10TH Street N.
St Petersburg, FL 33705-1407
Phone
(727) 824-7170
Fax
(727) 824-7142
NPI assigned
Jun 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY 744 FL Primary

Addresses

Primary practice location

620 10TH Street N.
St Petersburg, FL 33705-1407

Mailing address

PO Box 12868
St Petersburg, FL 33733-2868
Phone (727) 532-1355

Other identifiers 1

IdentifierTypeStateIssuer
004338301MedicaidFL

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
AY 744FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC CurrentSince Dec 7, 2020 Accepting new patients
Genesiscare USA of Florida LLC CurrentSince Dec 7, 2020 Accepting new patients
Andrew Marlowe, MD, PA CurrentSince Aug 5, 2024 Accepting new patients
Genesiscare USA of Florida LLC Current Accepting new patients
ENT and Allergy Associates of Florida, LLC Past Accepting new patients
Genesiscare USA of Florida LLC PastSince Dec 7, 2020 Accepting new patients

Locations

24 Del Prado Blvd N
Ste 100
Cape Coral, FL 33909
Phone (239) 772-2171

21 Barkley Cir
Fort Myers, FL 33907
Phone (239) 939-2616

39 Barkley Cir
Fort Myers, FL 33907
Phone (239) 936-1616

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

4937 Clark Rd
Ste 101
Sarasota, FL 34233
Phone (941) 379-3277

4120 Woodmere Park Blvd
Ste 8A
Venice, FL 34293
Phone (941) 408-8077

Organizations & group practices 6

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396224000000",
    "number": "1255536702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12868",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337332868",
            "telephone_number": "727-532-1355",
            "fax_number": "727-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH STREET N.",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-824-7170",
            "fax_number": "727-824-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "VICKI",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-15",
        "last_updated": "2014-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY 744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004338301",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2014; 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.