Individual provider Active NPI

Kay F. Ellison

  • Audiologist
  • Hannibal, MO
National Provider Identifier
1144290818
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2001005629 Issued in MO
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, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
335816708MedicaidMO

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. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

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.

Verify at the official NPI Registry.