Individual provider Active NPI

Kristine Terese Grbac-Schomaker, M.A. CCC-A

  • Audiologist
  • Bolivar, MO
National Provider Identifier
1043573256
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
01895 Issued in MO
Practice address
1500 N Oakland Ave
Bolivar, MO 65613-3011
Phone
(417) 326-6000
NPI assigned
Jun 21, 2012
Last updated
Jun 21, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 01895 MO Primary

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613-3011

Mailing address

2527 E Grand St
Springfield, MO 65804-0440
Phone (417) 838-7697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130509000180 MO Practitioner - Qualified Audiologist 5294972394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1165 N Butterfield Rd
BLDG B
Bolivar, MO 65613-1056
Phone (417) 838-7697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
01895MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearing and Audiology Sevices, LLC Audiologist Current Accepting new patients
Hearing and Audiology Sevices, LLC Audiologist CurrentSince Aug 1, 2012 Accepting new patients

Locations

1165 N Butterfield Rd
Bolivar, MO 65613
Phone (417) 777-6246

1165 N Butterfield Rd
Bldg B
Bolivar, MO 65613
Phone (417) 838-7697

1722 S Glenstone Ave
Ste J
Springfield, MO 65804
Phone (417) 229-2822

Networks

  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 2

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": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1043573256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2527 E GRAND ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658040440",
            "telephone_number": "417-838-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "656133011",
            "telephone_number": "417-326-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRBAC-SCHOMAKER",
        "first_name": "KRISTINE",
        "middle_name": "TERESE",
        "name_prefix": "Ms.",
        "credential": "M.A. CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "01895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.