Individual provider Active NPI

Kelsey Ilene Keimig, AU.D.

  • Audiologist
  • Jacksonville, FL
National Provider Identifier
1386129591
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2247 Issued in FL
Practice address
3627 University Blvd S
Jacksonville, FL 32216-4230
Phone
(904) 858-1912
NPI assigned
Oct 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01646 MD
Audiologist 231H00000X AY2247 FL Primary

Addresses

Primary practice location

3627 University Blvd S
Jacksonville, FL 32216-4230

Mailing address

119 Auburn Oaks Rd W
Jacksonville, FL 32218-4999
Phone (410) 812-1310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200409001327 FL Practitioner - Qualified Audiologist 4284063454 Reassigns benefits to 1 organization
I20231020002970 MD Practitioner - Qualified Audiologist 4284063454 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total ENT Care LLCGroup PAC ID 0042438814, 4 clinicians

Practice addresses (Care Compare)

1220 A E Joppa Rd
Suite 230D
Towson, MD 21286-5817
Phone (410) 889-0795

Merit-based Incentive Payment System (MIPS)

Final score
76.59 of 100Reported as group
Quality
55.66
Promoting interoperability
99
Improvement activities
40
Cost
62.26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jan 1, 2024 Accepting new patients
North Florida Surgeons, PA CurrentSince Jan 1, 2024 Accepting new patients
Total ENT Care LLC CurrentSince Jul 19, 2023 Accepting new patients

Locations

7135 NW 11th Pl
Ste A
Gainesville, FL 32605
Phone (352) 331-0090

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

3627 University Blvd S
Ste 500
Jacksonville, FL 32216
Phone (904) 399-1623

11945 San Jose Blvd
Ste 102
Jacksonville, FL 32223
Phone (904) 268-3937

733 W 40th St
Ste 20
Baltimore, MD 21211
Phone (443) 297-9693

1220A E Joppa Rd
Ste 230D
Towson, MD 21286
Phone (410) 299-1388

Interoperability endpoints

  • Direct secure messaging: kelsey.keimig@hca5.eclinicaldirectplus.com

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": "1538524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1386129591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AUBURN OAKS RD W",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184999",
            "telephone_number": "410-812-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3627 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164230",
            "telephone_number": "904-858-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIMIG",
        "first_name": "KELSEY",
        "middle_name": "ILENE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-03",
        "last_updated": "2023-11-16",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MD",
            "license": "01646",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.