Active NPI
Kay F. Ellison
- Audiologist
- Hannibal, MO
National Provider Identifier
1144290818
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2001005629
- Practice address
- 100 Medical Dr
Hannibal, MO 63401-6877 - Phone
- (573) 221-5250
- Fax
- (573) 231-3706
- NPI assigned
- Jan 25, 2006
- Last updated
- Nov 17, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2001005629 | MO | Primary |
Addresses
Primary practice location
100 Medical Dr
Hannibal, MO 63401-6877
Mailing address
100 Medical Dr
P.O. Box 311
Hannibal, MO 63401-6877
Phone (573) 221-5250
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 335816708 | Medicaid | MO |
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)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1144290818",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MEDICAL DR",
"address_2": "P.O. BOX 311",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016877",
"telephone_number": "573-221-5250",
"fax_number": "573-231-3706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MEDICAL DR",
"city": "HANNIBAL",
"state": "MO",
"postal_code": "634016877",
"telephone_number": "573-221-5250",
"fax_number": "573-231-3706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "KAY",
"middle_name": "F.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "2001005629",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "335816708",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hannibal, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.