Individual provider Active NPI

Susanna Leigh Bartel-Kelso, AUDIOLOGY

  • Audiologist
  • Newton, IA
National Provider Identifier
1407858764
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
00384 Issued in IA
Practice address
204 N 4TH Ave E
Newton, IA 50208-3135
Phone
(641) 792-1273
Fax
(641) 791-4852
NPI assigned
Jun 1, 2005
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 00384 IA Primary

Addresses

Primary practice location

204 N 4TH Ave E
Newton, IA 50208-3135

Mailing address

204 N 4TH Ave E
Newton, IA 50208-3135
Phone (641) 792-1273

Other identifiers 1

IdentifierTypeStateIssuer
0178756MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240604000966 IA Practitioner - Qualified Audiologist 2466994603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Iowa Hospital Corporation CurrentSince Apr 28, 2024 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Central Iowa Hospital Corporation CurrentSince Apr 28, 2024 Accepting new patients

Locations

410 NW Ash Dr
Ankeny, IA 50023
Phone (515) 964-1101

1200 Pleasant St
Ste P301A
Des Moines, IA 50309
Phone (515) 241-2865

204 N 4th Ave E
Newton, IA 50208
Phone (641) 791-4800

Interoperability endpoints

  • Direct secure messaging: sbartelkelso1060884@direct.unitypoint.org

Organizations & group practices 3

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": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1407858764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N 4TH AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083135",
            "telephone_number": "641-792-1273",
            "fax_number": "641-791-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N 4TH AVE E",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083135",
            "telephone_number": "641-792-1273",
            "fax_number": "641-791-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTEL-KELSO",
        "first_name": "SUSANNA",
        "middle_name": "LEIGH",
        "credential": "AUDIOLOGY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IA",
            "license": "00384",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0178756",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.