Individual provider Active NPI

Bailey Jeanette Latham, AUD

  • Audiologist
  • Saint Johns, FL
National Provider Identifier
1396429270
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY2716 Issued in FL
Practice address
75 Jaidev Rd
Saint Johns, FL 32259-1189
Phone
(904) 880-0911
NPI assigned
Jun 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY2716 FL Primary

Addresses

Primary practice location

75 Jaidev Rd
Saint Johns, FL 32259-1189

Mailing address

4203 Belfort Rd Ste 340
Jacksonville, FL 32216-1409
Phone (904) 880-0911

Other practice location 1

4203 Belfort Rd Ste 340
Jacksonville, FL 32216-1409
Phone (904) 880-0911

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726002394 FL Practitioner - Qualified Audiologist 2668833476 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Florida College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

4203 Belfort Rd
Suite 340
Jacksonville, FL 32216-1409
Phone (904) 880-0911

Merit-based Incentive Payment System (MIPS)

Final score
81.79 of 100Reported as group
Quality
64.42
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY2716FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Surgeons, PA CurrentSince Jun 12, 2023 Accepting new patients
North Florida Surgeons, PA CurrentSince Jun 12, 2023 Accepting new patients

Locations

1348 S 18th St
Ste 340
Fernandina Beach, FL 32034
Phone (904) 775-5957

11705 San Jose Blvd
Ste 103
Jacksonville, FL 32223
Phone (904) 880-0911

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

3 Shircliff Way
Ste 322
Jacksonville, FL 32204
Phone (904) 384-8088

2 Shircliff Way
Ste 920
Jacksonville, FL 32204
Phone (904) 308-1380

11945 San Jose Blvd
Ste 300
Jacksonville, FL 32223

4203 Belfort Rd
Ste 340
Jacksonville, FL 32216
Phone (904) 880-0911

Interoperability endpoints

  • Direct secure messaging: bailey.oliver.1@9109.direct.athenahealth.com

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": "1686528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1396429270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 BELFORT RD STE 340",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322161409",
            "telephone_number": "904-880-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 JAIDEV RD",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322591189",
            "telephone_number": "904-880-0911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4203 Belfort Rd Ste 340",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322161409",
            "country_code": "US",
            "telephone_number": "904-880-0911",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LATHAM",
        "first_name": "BAILEY",
        "middle_name": "JEANETTE",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-12",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY2716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.