Unknown Individual – Audiologist, NPI 1609879600

Unknown Individual is a healthcare provider. based in Fernandina beach, Florida. specializing in Audiologist. They hold a License No. AY641 (FL). The NPI Number for Unknown Individual is 1609879600

Main info

Organization
Inactive
24 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609879600
Phone
(904) 491-1515
Address
1411 S 14TH STREET, SUITE F
Deactivation Date
22 February 2023

Doctor Profile

Medical School Name
ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE MID WESTERN UNIVERSITY
Secondary Phone
-
Graduation Year
2002 (24 years ago)
PAC ID
3971781543
Professional Enrollment ID
I20110630000009
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 1411 S 14TH STREET, SUITE F

    AMELIA AUDIOLOGY

    FERNANDINA BEACH, FL 320343092

    Phone: (904) 491-1515

    Fax: (904) 491-1513

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32034)

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Provider's Procedures

Unknown Individual performs procedures in Audiologist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
QUALIFIED AUDIOLOGISTFL92567Eardrum testing using ear probe172172

Reviews

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Frequently asked questions

How do I look up Unknown Individual by NPI?
Use NPI 1609879600 when you need to reference Unknown Individual in forms, claims, or directories.
Should I trust care from Unknown Individual if status is inactive?
An inactive NPI does not by itself prove someone stopped practicing — check other sources.
What does Unknown Individual treat or focus on?
Patients typically see Unknown Individual under the specialty Audiologist. Clinical services aligned with this taxonomy classification.
What location metadata exists for Unknown Individual?
The page summarizes Fernandina Beach, Florida for Unknown Individual; expand the address list for detail.
Is Unknown Individual a real provider?
This page reflects official NPPES data for NPI 1609879600. Always confirm identity and privileges with the practice and licensing boards.

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