Individual provider Active NPI

Jacqueline Scott Hartman, M.A.,CCC

  • Audiologist
  • Ellisville, MO
National Provider Identifier
1356488092
Registry record updated Nov 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
536 Issued in MO
Practice address
15991 Manchester Rd
Ellisville, MO 63011-2140
Phone
(636) 394-4240
NPI assigned
Jan 31, 2007
Last updated
Nov 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2023

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
536MOMDAssistive Technology Supplier Audiologist
624MOMDHearing 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.

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.

Verify at the official NPI Registry.