Individual provider Active NPI

Elizabeth A Gansen, AU.D

  • Audiologist
  • Liberty, MO
National Provider Identifier
1063897403
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2015024035 Issued in MO
Practice address
2521 Glenn Hendren Dr Ste 104
Liberty, MO 64068-3388
Phone
(816) 781-1001
Fax
(816) 792-0408
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2015024035 MO Primary

Addresses

Primary practice location

2521 Glenn Hendren Dr Ste 104
Liberty, MO 64068-3388

Mailing address

2521 Glenn Hendren Dr Ste 104
Liberty, MO 64068-3388
Phone (816) 781-0352

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812008353 MO Practitioner - Qualified Audiologist 8224343710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Wisconsin School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Liberty Hospital CorporationGroup PAC ID 9931166618, 135 clinicians

Practice addresses (Care Compare)

2521 Glenn Hendren Dr
Suite 104
Liberty, MO 64068-3388
Phone (816) 781-1001

Merit-based Incentive Payment System (MIPS)

Final score
81.21 of 100Reported as group
Quality
69.99
Promoting interoperability
99
Improvement activities
40
Cost
68.22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2300KSMDRegistered Dietitian
2015024035MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
New Liberty Hospital Corporation CurrentSince Jan 30, 2019 Accepting new patients
New Liberty Hospital Coporation CurrentSince Jan 30, 2019 Accepting new patients
New Liberty Hospital Corporation Current Accepting new patients
New Liberty Hospital Coporation Past Accepting new patients

Locations

305 S Platte Clay Way
Kearney, MO 64060
Phone (816) 628-4409

2609 Glenn Hendren Dr
Liberty, MO 64068
Phone (816) 407-4555

2521 Glenn Hendren Dr
Ste 410
Liberty, MO 64068
Phone (816) 415-3437

2521 Glenn Hendren Dr
Ste 104
Liberty, MO 64068
Phone (816) 781-0352

Interoperability endpoints

  • Direct secure messaging: nielsenmsccca.tanya.p9@direct.nlhc.nextgenshare.com
  • Direct secure messaging: elizabeth.gansen.p9@direct.nlhc.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1063897403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR STE 104",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-781-0352",
            "fax_number": "816-875-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 GLENN HENDREN DR STE 104",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "640683388",
            "telephone_number": "816-781-1001",
            "fax_number": "816-792-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANSEN",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2015024035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Liberty, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.