Active NPI
Susan Elizabeth Herrmann-Ekstam, MS, CCC-A, FAAA
- Audiologist
- Springfield, MO
National Provider Identifier
1316371990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 120022
- Practice address
- 3242 S National Ave
Springfield, MO 65807-7303 - Phone
- (417) 889-5353
- Fax
- (417) 889-5355
- NPI assigned
- Aug 30, 2013
- 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 | 120022 | MO | Primary |
Addresses
Primary practice location
3242 S National Ave
Springfield, MO 65807-7303
Mailing address
3242 S National Ave
Springfield, MO 65807-7303
Phone (417) 889-5353
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120022 | MO | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377820800000",
"number": "1316371990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3242 S NATIONAL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658077303",
"telephone_number": "417-889-5353",
"fax_number": "417-889-5355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3242 S NATIONAL AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658077303",
"telephone_number": "417-889-5353",
"fax_number": "417-889-5355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HERRMANN-EKSTAM",
"first_name": "SUSAN",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "MS, CCC-A, FAAA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-30",
"last_updated": "2013-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "120022",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.