Individual provider Active NPI

Mary Kochendorfer, AUD

  • Audiologist
  • Stillwater, MN
National Provider Identifier
1235364209
Registry record updated Feb 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone
(651) 439-1234
Fax
(651) 439-1547
NPI assigned
May 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Mailing address

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040
Phone (651) 439-1234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090825000616 MN Practitioner - Qualified Audiologist 5092860106 Reassigns benefits to 1 organization
I20160209001443 WI Practitioner - Qualified Audiologist 5092860106 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Group Health Plan Inc CurrentSince Jan 1, 2016 Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Jan 1, 2016 Accepting new patients

Locations

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

1500 Curve Crest Blvd W
Stillwater, MN 55082

921 Greeley St S
West Lakeland, MN 55082

700 Rivard St
Somerset, WI 54025
Phone (715) 247-2060

744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251

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": "1242777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297728000000",
    "number": "1235364209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234",
            "fax_number": "651-439-1547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234",
            "fax_number": "651-439-1547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOCHENDORFER",
        "first_name": "MARY",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-20",
        "last_updated": "2011-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.