Individual provider Active NPI

Jacklynn Teal Neutz Lacefield, AUD

  • Audiologist
  • Louisville, KY
National Provider Identifier
1457784134
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
267989 Issued in KY
Practice address
729 Speckman Rd
Louisville, KY 40243-1876
Phone
(502) 539-5000
NPI assigned
Aug 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 267989 KY Primary

Addresses

Primary practice location

729 Speckman Rd
Louisville, KY 40243-1876

Mailing address

729 Speckman Rd
Louisville, KY 40243-1876
Phone (502) 539-5000

Other names 1

  • Jacklynn Teal Neutz Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807004333 KY Practitioner - Qualified Audiologist 2466696398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3002CAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami Past Accepting new patients
University of Miami Past Accepting new patients

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": "1376611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1457784134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 SPECKMAN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431876",
            "telephone_number": "502-539-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 SPECKMAN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402431876",
            "telephone_number": "502-539-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACEFIELD",
        "first_name": "JACKLYNN",
        "middle_name": "TEAL NEUTZ",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-16",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "267989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKLYNN",
            "last_name": "NEUTZ",
            "middle_name": "TEAL",
            "credential": "AUD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.

Verify at the official NPI Registry.