Individual provider Active NPI

Susan Elizabeth Smittkamp, PH.D.

  • Audiologist
  • Shawnee Mission, KS
National Provider Identifier
1306104153
Registry record updated Apr 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2216 Issued in KS
Practice address
8800 W 75TH St Ste 101
Shawnee Mission, KS 66204-4001
Phone
(913) 403-0018
Fax
(913) 482-3169
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2216 KS Primary

Addresses

Primary practice location

8800 W 75TH St Ste 101
Shawnee Mission, KS 66204-4001

Mailing address

8800 W 75TH St Ste 101
Shawnee Mission, KS 66204-4001
Phone (913) 384-2105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120809000195 KS Practitioner - Qualified Audiologist 4082860911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associated Audiologists IncGroup PAC ID 4183693187, 15 clinicians

Practice addresses (Care Compare)

8800 W 75TH St
Suite 101
Shawnee Mission, KS 66204-4001
Phone (913) 403-0018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2216KSMDAudiologist

Organizations & group practices 1

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335744000000",
    "number": "1306104153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 W 75TH ST STE 101",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044001",
            "telephone_number": "913-384-2105",
            "fax_number": "913-384-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 W 75TH ST STE 101",
            "city": "SHAWNEE MISSION",
            "state": "KS",
            "postal_code": "662044001",
            "telephone_number": "913-403-0018",
            "fax_number": "913-482-3169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITTKAMP",
        "first_name": "SUSAN",
        "middle_name": "ELIZABETH",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2012-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "2216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawnee Mission, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2012; 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.