Individual provider Active NPI

Gregory Kyle Clifton, AU.D.

  • Audiologist
  • Orlando, FL
National Provider Identifier
1376957910
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1871 Issued in FL
Practice address
11602 Lake Underhill Rd Ste 130
Orlando, FL 32825-4460
Phone
(407) 635-8497
Fax
(407) 627-1680
NPI assigned
Jun 11, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X
Audiologist-Hearing Aid Fitter 237600000X AY1871 FL
Hearing Instrument Specialist 237700000X
Audiologist 231H00000X AY1871 FL Primary

Addresses

Primary practice location

11602 Lake Underhill Rd Ste 130
Orlando, FL 32825-4460

Mailing address

11602 Lake Underhill Rd Ste 130
Orlando, FL 32825-4460
Phone (407) 635-8497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140908001988 FL Practitioner - Qualified Audiologist 4385863299 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11602 Lake Underhill Rd
Suite 130
Orlando, FL 32825-4460
Phone (407) 635-8497

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY1871FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
East Orlando Audiology Hearing & Wellness Audiologist CurrentSince Sep 3, 2020 Accepting new patients

Locations

11602 Lake Underhill Rd
Ste 130
Orlando, FL 32825
Phone (407) 635-8497

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1376957910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11602 LAKE UNDERHILL RD STE 130",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254460",
            "telephone_number": "407-635-8497",
            "fax_number": "407-627-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11602 LAKE UNDERHILL RD STE 130",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328254460",
            "telephone_number": "407-635-8497",
            "fax_number": "407-627-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIFTON",
        "first_name": "GREGORY",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-11",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "FL",
            "license": "AY1871",
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.