Patrick J Conlon, HAS, BC-HIS

Key facts

NPI

1457785701

Entity type

Individual (NPI type 1)

Primary specialty

Hearing Instrument Specialist 237700000X

License

AS1699 (FL)

Practice address

490 Avenue K SE
Winter Haven, FL 33880-4125

Phone

(863) 294-8353

Fax

(863) 299-0334

NPI assigned

Aug 22, 2013

Sex

Male

Sole proprietor

Yes

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.

• PKC, Inc. Hearing Instrument Specialist · Winter Haven, FL · NPI 1700800133
  NPD (past) Authorized official HEARING INSTRUMENT SPECIALIST
• Audiology Distribution, LLC Audiologist-Hearing Aid Fitter · Dublin, OH · NPI 1164707998
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles (2 of 4)

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 22, 2013.

{
    "created_epoch": "1377129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377129600000",
    "number": "1457785701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804125",
            "telephone_number": "863-294-8353",
            "fax_number": "863-299-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 AVENUE K SE",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338804125",
            "telephone_number": "863-294-8353",
            "fax_number": "863-299-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONLON",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "HAS, BC-HIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-22",
        "last_updated": "2013-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS1699",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEARUSA",
            "identifier": "07878",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "085215500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS INSURANCE",
            "identifier": "J0507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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All providers in Winter Haven, FL · Hearing Instrument Specialist in Florida