Individual provider Active NPI

Connie Anne Kushch

  • Audiologist
  • Fort Lauderdale, FL
National Provider Identifier
1477040418
Registry record updated Apr 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY119 Issued in FL
Practice address
5353 N Federal Hwy Ste 207
Fort Lauderdale, FL 33308-3236
Phone
(954) 562-3274
Fax
(954) 533-1937
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AY119 FL Primary

Addresses

Primary practice location

5353 N Federal Hwy Ste 207
Fort Lauderdale, FL 33308-3236

Mailing address

9900 N Abiaca Cir
Davie, FL 33328-7126
Phone (954) 562-3274

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AY119FLMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Connie Kushch Au.D., LLC Audiologist Past Accepting new patients
Alexander Kushch, PHD, PA 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": "1523836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1477040418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9900 N ABIACA CIR",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333287126",
            "telephone_number": "954-562-3274",
            "fax_number": "954-533-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 N FEDERAL HWY STE 207",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083236",
            "telephone_number": "954-562-3274",
            "fax_number": "954-533-1937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSHCH",
        "first_name": "CONNIE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-16",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.