Individual provider Active NPI

Clare Cronin, AUD, CCC-A

  • Audiologist
  • Fort Myers, FL
National Provider Identifier
1578536595
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AY 1451 Issued in FL
Practice address
4550 Colonial Blvd
Fort Myers, FL 33966-1017
Phone
(239) 931-5700
Fax
(239) 931-5738
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 147-000969 IL
Audiologist 231H00000X AY 1451 FL Primary

Addresses

Primary practice location

4550 Colonial Blvd
Fort Myers, FL 33966-1017

Mailing address

4550 Colonial Blvd
Fort Myers, FL 33966-1017
Phone (239) 931-5700

Other identifiers 1

IdentifierTypeStateIssuer
600550100MedicaidFL

Other names 1

  • Clare Dolter Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
AY 1451FLMDAudiologist
147-000969ILMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1578536595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661017",
            "telephone_number": "239-931-5700",
            "fax_number": "239-931-5738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661017",
            "telephone_number": "239-931-5700",
            "fax_number": "239-931-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "CLARE",
        "credential": "AUD, CCC-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IL",
            "license": "147-000969",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "FL",
            "license": "AY 1451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600550100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLARE",
            "last_name": "DOLTER",
            "credential": "M.A., CCC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; 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.