Lee Supitilov

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

2016039127 Issued in MO

Practice address

3797 Osage Beach Pkwy
Osage Beach, MO 65065-2186

Phone

(573) 302-0340

Fax

(573) 302-0393

NPI assigned

Apr 21, 2017

Last updated

Apr 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Audiology & Hearing Center of Farmington, Inc

  • Audiologist-Hearing Aid Fitter
  • Farmington, MO
  • NPI 1124060561
  NPD (past)

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

{
    "created_epoch": "1492732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492732800000",
    "number": "1174058606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3797 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652186",
            "telephone_number": "573-302-0340",
            "fax_number": "573-302-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3797 OSAGE BEACH PKWY",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650652186",
            "telephone_number": "573-302-0340",
            "fax_number": "573-302-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPITILOV",
        "first_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-21",
        "last_updated": "2017-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MO",
            "license": "2016039127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Renee Spies, PHARM D.
• Springfield Neurological and Spine Institute
• Mark B Stevens, PSYD
• Brooke Elizabeth Stone, COTA/L
• Tasha Stuckenschneider
• William Supitilov
• Surgical Institute of Lake of the Ozarks LLC
• Susan Elaine Mitchell (Heavenly Soles Foot Comfort Center)
• Lauren Elizabeth Taylor, OTR/L
• Jordan Alaine Teeple, MS, RD, LD

• Hearing Instrument Specialist in Osage Beach, MO
• Providers in Osage Beach, MO by specialty
• Hearing Instrument Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.