Individual provider Active NPI

Angela Michele Gillentine, AU.D.

  • Audiologist
  • Saint Louis, MO
National Provider Identifier
1518024918
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2022039713 Issued in MO
Practice address
1010 Old Des Peres Rd
Saint Louis, MO 63131-1865
Phone
(314) 729-0077
Fax
(314) 729-0101
NPI assigned
Jan 3, 2007
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 51020 TX
Audiologist 231H00000X 2022039713 MO Primary
Audiologist-Hearing Aid Fitter 237600000X 2022039713 MO
Audiologist-Hearing Aid Fitter 237600000X 51020 TX

Addresses

Primary practice location

1010 Old Des Peres Rd
Saint Louis, MO 63131-1865

Mailing address

3264 State Highway 110
Grand Saline, TX 75140-5098
Phone (972) 747-1333

Other practice location 1

501 W Pine St
Farmington, MO 63640-1439
Phone (573) 756-8888

Other practice location 2

915 W Exchange Pkwy
Suite 180-A
Allen, TX 75013-7017
Phone (972) 747-1333

Other identifiers 6

IdentifierTypeStateIssuer
33-1023289OtherTXFEDERAL TAX ID
331023289OtherUNITED HEALTH CARE
430835090OtherMOTAX ID
528407OtherTXBLUECROSS AND BLUESHIELD
7065317OtherTXAETNA
1469165-04MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060217000482 TX Practitioner - Qualified Audiologist 9739194382 Reassigns benefits to 1 organization
I20260605000506 MO Practitioner - Qualified Audiologist 9739194382 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Oklahoma College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Practice addresses (Care Compare)

1010 Old Des Peres Rd
Des Peres, MO 63131-1865
Phone (314) 729-0077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excelhealth Group LLC Audiologist CurrentSince Nov 1, 2025 Accepting new patients
Allen Hearing Clinic, Inc. Past Accepting new patients
Audigycare, LLC Audiologist-Hearing Aid Fitter Past Accepting new patients

Locations

605 River Rock Blvd
Murfreesboro, TN 37128

4195 Milam St
Beaumont, TX 77707
Phone (409) 842-4450

7633 Bellfort St
Houston, TX 77061
Phone (713) 644-2101

Organizations & group practices 5

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": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1518024918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 STATE HIGHWAY 110",
            "city": "GRAND SALINE",
            "state": "TX",
            "postal_code": "751405098",
            "telephone_number": "972-747-1333",
            "fax_number": "972-747-1132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 OLD DES PERES RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631311865",
            "telephone_number": "314-729-0077",
            "fax_number": "314-729-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Pine St",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401439",
            "country_code": "US",
            "telephone_number": "573-756-8888",
            "fax_number": "573-701-9547",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 W Exchange Pkwy",
            "address_2": "Suite 180-A",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750137017",
            "country_code": "US",
            "telephone_number": "972-747-1333",
            "fax_number": "972-747-1132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLENTINE",
        "first_name": "ANGELA",
        "middle_name": "MICHELE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "51020",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2022039713",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MO",
            "license": "2022039713",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "51020",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "33-1023289",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "331023289",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "430835090",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "528407",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7065317",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1469165-04",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.