Active NPI
Jacqueline Scott Hartman, M.A.,CCC
- Audiologist
- Ellisville, MO
National Provider Identifier
1356488092
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 536
- Practice address
- 15991 Manchester Rd
Ellisville, MO 63011-2140 - Phone
- (636) 394-4240
- NPI assigned
- Jan 31, 2007
- Last updated
- Nov 15, 2023
- 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 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistive Technology Practitioner Audiologist | 231HA2400X | 536 | MO | |
| Assistive Technology Supplier Audiologist | 231HA2500X | 536 | MO | |
| Speech-Language Pathologist | 235Z00000X | 536 | MO | |
| Audiologist-Hearing Aid Fitter | 237600000X | 624 | MO | |
| Hearing Instrument Specialist | 237700000X | 624 | MO | |
| Audiologist | 231H00000X | 536 | MO | Primary |
Addresses
Primary practice location
15991 Manchester Rd
Ellisville, MO 63011-2140
Mailing address
15991 Manchester Rd
Ellisville, MO 63011-2140
Phone (636) 394-4240
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 536 | MO | MD | Assistive Technology Supplier Audiologist |
| 624 | MO | MD | Hearing Instrument Specialist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ellisville Hearing Center and Hearing Center of Kirkwood
- Audiologist-Hearing Aid Fitter
- Ellisville, MO
- NPI 1053458612
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700006400000",
"number": "1356488092",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15991 MANCHESTER RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112140",
"telephone_number": "636-394-4240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15991 MANCHESTER RD",
"city": "ELLISVILLE",
"state": "MO",
"postal_code": "630112140",
"telephone_number": "636-394-4240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTMAN",
"first_name": "JACQUELINE",
"middle_name": "SCOTT",
"name_prefix": "Ms.",
"credential": "M.A.,CCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2023-11-15",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "231HA2400X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Practitioner",
"state": "MO",
"license": "536",
"primary": false
},
{
"code": "231HA2500X",
"taxonomy_group": "",
"desc": "Audiologist, Assistive Technology Supplier",
"state": "MO",
"license": "536",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "536",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "MO",
"license": "624",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "MO",
"license": "624",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MO",
"license": "536",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ellisville, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.