Active NPI
Brenda R. McDonnell, AU.D.
- Audiologist-Hearing Aid Fitter
- Tallahassee, FL
National Provider Identifier
1407016017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist-Hearing Aid Fitter
- License
- AY863
- Practice address
- 1907 Capital Cir NE
Tallahassee, FL 32308-4421 - Phone
- (850) 222-4434
- Fax
- (850) 222-4434
- NPI assigned
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1039A | AL | |
| Assistive Technology Practitioner Audiologist | 231HA2400X | 1039A | AL | |
| Audiologist | 231H00000X | AY863 | FL | |
| Assistive Technology Practitioner Audiologist | 231HA2400X | AY863 | FL | |
| Assistive Technology Supplier Audiologist | 231HA2500X | AY863 | FL | |
| Assistive Technology Supplier Audiologist | 231HA2500X | 1039A | AL | |
| Audiologist-Hearing Aid Fitter | 237600000X | 1039A | AL | |
| Audiologist-Hearing Aid Fitter | 237600000X | AY863 | FL | Primary |
Addresses
Primary practice location
1907 Capital Cir NE
Tallahassee, FL 32308-4421
Mailing address
1907 Capital Cir NE
Tallahassee, FL 32308-4421
Phone (850) 222-4434
Other practice location 1
5043 Bayou Blvd
Pensacola, FL 32503-2528
Phone (850) 291-9761
Other practice location 2
602 Victoria Pl Ste B
Thomasville, GA 31792-6687
Phone (229) 227-1750
Other practice location 3
402 S West St
Bainbridge, GA 39819-3914
Phone (229) 246-5885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000825500 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, GA
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AY863 | FL | MD | Assistive Technology Practitioner Audiologist |
| 1039A | AL | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Speech and Hearing Specialists, Inc | Audiologist | Past | Accepting new patients |
| GN Hearing Care Corp | Past | Accepting new patients |
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.
-
- Audiologist
- Ocala, FL
- NPI 1790907145
-
- Hearing Instrument Specialist
- Dothan, AL
- NPI 1073657821
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691539200000",
"number": "1407016017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1907 CAPITAL CIR NE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084421",
"telephone_number": "850-222-4434",
"fax_number": "850-222-4434"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1907 CAPITAL CIR NE",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084421",
"telephone_number": "850-222-4434",
"fax_number": "850-222-4434"
}
],
"practiceLocations": [
{
"address_1": "5043 Bayou Blvd",
"address_purpose": "LOCATION",
"city": "Pensacola",
"state": "FL",
"postal_code": "325032528",
"country_code": "US",
"telephone_number": "850-291-9761",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "602 Victoria Pl Ste B",
"address_purpose": "LOCATION",
"city": "Thomasville",
"state": "GA",
"postal_code": "317926687",
"country_code": "US",
"telephone_number": "229-227-1750",
"fax_number": "850-222-4434",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "402 S West St",
"address_purpose": "LOCATION",
"city": "Bainbridge",
"state": "GA",
"postal_code": "398193914",
"country_code": "US",
"telephone_number": "229-246-5885",
"fax_number": "850-222-4434",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MCDONNELL",
"first_name": "BRENDA",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2023-08-09",
"certification_date": "2023-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AL",
"license": "1039A",
"primary": false
},
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "AL",
"license": "1039A",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "FL",
"license": "AY863",
"primary": false
},
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "FL",
"license": "AY863",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "FL",
"license": "AY863",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "AL",
"license": "1039A",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "AL",
"license": "1039A",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "FL",
"license": "AY863",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000825500",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.