Individual provider Active NPI

Marlisa Wootton, AUD

  • Audiologist
  • Boulder, CO
National Provider Identifier
1396538658
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD.0001330 Issued in CO
Practice address
4800 Baseline Rd Ste E108
Boulder, CO 80303-2643
Phone
(303) 499-3900
Fax
(303) 499-9506
NPI assigned
May 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AUD.0001330 CO Primary

Addresses

Primary practice location

4800 Baseline Rd Ste E108
Boulder, CO 80303-2643

Mailing address

1315 Vivian St
Longmont, CO 80501-3216
Phone (303) 776-8748

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250626002240 CO Practitioner - Qualified Audiologist 9830601582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whitney Swander Audiology, IncGroup PAC ID 7618031980, 7 clinicians

Practice addresses (Care Compare)

4800 Baseline Rd
E108 Hearing Healthcare Centers
Boulder, CO 80303-2643
Phone (303) 499-3900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD.0001330COMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Whitney Swander Audiology, Inc Audiologist CurrentSince May 19, 2025 Accepting new patients

Locations

4800 Baseline Rd
Ste E108
Boulder, CO 80303
Phone (303) 499-3900

1315 Vivian St
Longmont, CO 80501
Phone (303) 776-8748

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": "1748390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1396538658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 VIVIAN ST",
            "city": "LONGMONT",
            "state": "CO",
            "postal_code": "805013216",
            "telephone_number": "303-776-8748",
            "fax_number": "303-684-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 BASELINE RD STE E108",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032643",
            "telephone_number": "303-499-3900",
            "fax_number": "303-499-9506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTTON",
        "first_name": "MARLISA",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-28",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CO",
            "license": "AUD.0001330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; 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.