Active NPI
Kenton Stephen Tarver, AUD
- Audiologist
- Largo, FL
National Provider Identifier
1629053830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AY1318
- Practice address
- 8200 Bryan Dairy Rd
Suite 340
Largo, FL 33777 - Phone
- (727) 398-5728
- Fax
- (727) 398-4914
- NPI assigned
- Dec 9, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | AY1318 | FL | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | AY1318 | FL |
Addresses
Primary practice location
8200 Bryan Dairy Rd
Suite 340
Largo, FL 33777
Mailing address
8200 Bryan Dairy Rd
Suite 340
Largo, FL 33777
Phone (727) 398-5728
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| S9133 | Other | FL | BCBS |
| 33023 | Other | FL | MEDICARE GROUP # |
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
| License | State | Type | Specialty |
|---|---|---|---|
| AY1318 | FL | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| American Institute of Balance Inc | Audiologist-Hearing Aid Fitter | Past | Accepting new patients |
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.
-
- Audiologist-Hearing Aid Fitter
- Largo, FL
- NPI 1851392849
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269820800000",
"number": "1629053830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8200 BRYAN DAIRY RD",
"address_2": "SUITE 340",
"city": "LARGO",
"state": "FL",
"postal_code": "33777",
"telephone_number": "727-398-5728",
"fax_number": "727-398-4914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8200 BRYAN DAIRY RD",
"address_2": "SUITE 340",
"city": "LARGO",
"state": "FL",
"postal_code": "33777",
"telephone_number": "727-398-5728",
"fax_number": "727-398-4914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARVER",
"first_name": "KENTON",
"middle_name": "STEPHEN",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-09",
"last_updated": "2010-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "FL",
"license": "AY1318",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "FL",
"license": "AY1318",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "S9133",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE GROUP #",
"identifier": "33023",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Largo, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.