Individual provider Active NPI

Jody Edwards Chesser, AUD

  • Audiologist
  • Fort Walton Beach, FL
National Provider Identifier
1447581806
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1408 Issued in FL
Practice address
339 Racetrack Rd NW Ste 20
Fort Walton Beach, FL 32547-1581
Phone
(850) 863-4327
Fax
(850) 243-8741
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY1408 FL Primary

Addresses

Primary practice location

339 Racetrack Rd NW Ste 20
Fort Walton Beach, FL 32547-1581

Mailing address

339 Racetrack Rd NW Ste 20
Fort Walton Beach, FL 32547-1581
Phone (850) 863-4327

Other identifiers 1

IdentifierTypeStateIssuer
001802501MedicaidFL

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

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363305600000",
    "number": "1447581806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 RACETRACK RD NW STE 20",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471581",
            "telephone_number": "850-863-4327",
            "fax_number": "850-243-8741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 RACETRACK RD NW STE 20",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325471581",
            "telephone_number": "850-863-4327",
            "fax_number": "850-243-8741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHESSER",
        "first_name": "JODY",
        "middle_name": "EDWARDS",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2013-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1408",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001802501",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.