Active NPI
Jeffrey Berdahl
- Hearing Instrument Specialist
- Lake Wales, FL
National Provider Identifier
1588901516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- AS2231
- Practice address
- 301 Eagle Ridge Dr
Lake Wales, FL 33859-4751 - Phone
- (863) 679-2066
- Fax
- (863) 676-1601
- NPI assigned
- Jan 10, 2013
- Last updated
- Jan 10, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | AS2231 | FL | Primary |
Addresses
Primary practice location
301 Eagle Ridge Dr
Lake Wales, FL 33859-4751
Mailing address
PO Box 531027
St Petersburg, FL 33747-1027
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
| License | State | Type | Specialty |
|---|---|---|---|
| AS2231 | FL | MD | Hearing Instrument Specialist |
Networks
- Freedom Health HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357776000000",
"number": "1588901516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 531027",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337471027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 EAGLE RIDGE DR",
"city": "LAKE WALES",
"state": "FL",
"postal_code": "338594751",
"telephone_number": "863-679-2066",
"fax_number": "863-676-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERDAHL",
"first_name": "JEFFREY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-01-10",
"last_updated": "2013-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "FL",
"license": "AS2231",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Wales, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.