Individual provider Active NPI

Jayda Allen, AUD

  • Audiologist
  • St Petersburg, FL
National Provider Identifier
1487399747
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1430 66TH St N
St Petersburg, FL 33710-5504
Phone
(866) 391-2313
NPI assigned
May 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

1430 66TH St N
St Petersburg, FL 33710-5504

Mailing address

2040 Lakewood Club Dr S Unit 1H
St Petersburg, FL 33712-6402
Phone (163) 162-7444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220822001124 FL Practitioner - Qualified Audiologist 7012390206 Reassigns benefits to 1 organization
I20250709000956 NY Practitioner - Qualified Audiologist 7012390206 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003293NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Distribution, LLC CurrentSince Aug 10, 2022 Accepting new patients

Locations

1900 Tamiami Trl
Unit 109
Port Charlotte, FL 33948
Phone (941) 743-5211

1430 66th St N
St Petersburg, FL 33710
Phone (727) 343-3019

7232 Austin St
Forest Hills, NY 11375
Phone (718) 577-5121

1776 Broadway
New York, NY 10019
Phone (212) 399-7329

Organizations & group practices 1

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": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1487399747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 LAKEWOOD CLUB DR S UNIT 1H",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337126402",
            "telephone_number": "163-162-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 66TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105504",
            "telephone_number": "866-391-2313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JAYDA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.