Individual provider Active NPI

Kelsey Siebenmorgen

  • Audiologist
  • Springdale, AR
National Provider Identifier
1033739354
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
5344 Issued in OK
Practice address
6823 Isaacs Orchard Rd
Springdale, AR 72762-6096
Phone
(479) 750-2080
Fax
(479) 750-2082
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 5344 OK Primary

Addresses

Primary practice location

6823 Isaacs Orchard Rd
Springdale, AR 72762-6096

Mailing address

6823 Isaacs Orchard Rd
Springdale, AR 72762-6096
Phone (479) 750-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200727000744 TX Practitioner - Qualified Audiologist 4183048929 Reassigns benefits to 1 organization
I20240830003510 AR Practitioner - Qualified Audiologist 4183048929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Arkansas College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Manning,Johnson and Spencer, PAGroup PAC ID 3870594641, 10 clinicians

Practice addresses (Care Compare)

6823 Isaac's Orchard Rd
Springdale, AR 72762-6096
Phone (479) 750-2080

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
Quality
72.78
Promoting interoperability
98
Improvement activities
40
Cost
76.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5344OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation Current Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2020 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Manning,Johnson & Spencer, PA CurrentSince Jul 17, 2024 Accepting new patients
Cherokee Nation CurrentSince Jul 1, 2020 Accepting new patients

Locations

859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271

1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201

1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192

900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500

100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100

19600 E Ross St
Tahlequah, OK 74464
Phone (539) 234-1000

Dept 2269
Tulsa, OK 74182

27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1033739354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6823 ISAACS ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626096",
            "telephone_number": "479-750-2080",
            "fax_number": "479-750-2082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6823 ISAACS ORCHARD RD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727626096",
            "telephone_number": "479-750-2080",
            "fax_number": "479-750-2082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIEBENMORGEN",
        "first_name": "KELSEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "5344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.