Individual provider Active NPI

Caroline Stewart-Glaze

  • Audiologist
  • Saint Louis, MO
National Provider Identifier
1700338282
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2016023471 Issued in MO
Practice address
3860 S Lindbergh Blvd
#108
Saint Louis, MO 63127-1373
Phone
(314) 729-0077
Fax
(314) 729-0101
NPI assigned
Oct 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2016023471 MO Primary

Addresses

Primary practice location

3860 S Lindbergh Blvd
#108
Saint Louis, MO 63127-1373

Mailing address

PO Box 790379
Saint Louis, MO 63179-0379
Phone (314) 729-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161121000846 MO Practitioner - Qualified Audiologist 6002195765 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
West Virginia University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone (636) 251-6000

615 S New Ballas Rd Administration B
St Louis, MO 63141-8221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospitals East Communities Current Accepting new patients
Mercy Hospitals East Communities CurrentSince May 2, 2022 Accepting new patients
Mercy Hospitals East Communities Audiologist CurrentSince Feb 22, 2021 Accepting new patients
Mercy Hospitals East Communities CurrentSince May 2, 2022 Accepting new patients
Mercy Hospitals East Communities CurrentSince Feb 22, 2021 Accepting new patients

Locations

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

607 S New Ballas Rd
Ste T2170
Saint Louis, MO 63141
Phone (314) 251-4235

607 S New Ballas Rd
Ste 2300
Saint Louis, MO 63141
Phone (314) 251-6394

901 E 5th St
Washington, MO 63090
Phone (636) 239-8000

901 Patients First Dr
Ste 3500
Washington, MO 63090
Phone (636) 390-1570

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1700338282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790379",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631790379",
            "telephone_number": "314-729-0077",
            "fax_number": "314-729-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3860 S LINDBERGH BLVD",
            "address_2": "#108",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271373",
            "telephone_number": "314-729-0077",
            "fax_number": "314-729-0101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART-GLAZE",
        "first_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-31",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2016023471",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 13, 2019; 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.