NPIMap

Organization Active NPI

Lakeland Professional Hearing Center, Inc.

  • Audiologist
  • Lakeland, FL
National Provider Identifier
1508047291
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY1201 Issued in FL
Legal business name
LAKELAND PROFESSIONAL HEARING CENTER, INC.
Practice address
5353 N Socrum Loop Rd
Lakeland, FL 33809-4256
Phone
(863) 859-0754
Fax
(863) 859-4630
NPI assigned
Nov 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Authorized official

Name
Mrs. Tonya L Showalter, M.S.
Title
Audiologist/Ceo
Phone
(863) 859-0754

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X AY1201 FL Primary

Addresses

Primary practice location

5353 N Socrum Loop Rd
Lakeland, FL 33809-4256

Mailing address

5353 N Socrum Loop Rd
Lakeland, FL 33809-4256
Phone (863) 859-0754

Other identifiers 1

IdentifierTypeStateIssuer
S2917OtherFLBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

5353 N Socrum Loop Rd
Lakeland, FL 33809
Phone (863) 859-0754

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195603200000",
    "number": "1508047291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 N SOCRUM LOOP RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094256",
            "telephone_number": "863-859-0754",
            "fax_number": "863-859-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 N SOCRUM LOOP RD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338094256",
            "telephone_number": "863-859-0754",
            "fax_number": "863-859-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKELAND PROFESSIONAL HEARING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A",
        "authorized_official_last_name": "SHOWALTER",
        "authorized_official_first_name": "TONYA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUDIOLOGIST/CEO",
        "authorized_official_telephone_number": "863-859-0754",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY1201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "S2917",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2007; 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.