Individual provider Active NPI

Michelle Lynn Betner, HAD & SLP

  • Audiologist
  • Baltimore, MD
National Provider Identifier
1710010947
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2009001280 Issued in MO
Practice address
6565 N Charles St
Ppe Suite 601
Baltimore, MD 21204-6800
Phone
(410) 821-5151
Fax
(410) 823-8309
NPI assigned
Mar 14, 2007
Last updated
Jan 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 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 2009001280 MO Primary

Addresses

Primary practice location

6565 N Charles St
Ppe Suite 601
Baltimore, MD 21204-6800

Mailing address

9701 Landmark Parkway Dr
Ste 201
Saint Louis, MO 63127-1665
Phone (314) 843-3828

Other names 1

  • Miss Michelle Lynn Thompson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100512001050 MO Practitioner - Qualified Audiologist 5092882860 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2009001280MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gwent LLC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients
Alderman & Lumpkin Et Al Single Specialty PastSince Jun 10, 2010 Accepting new patients
Gateway Audiology LLC Single Specialty PastSince Aug 28, 2022 Accepting new patients

Locations

1400 US Highway 61
Ste G40
Crystal Cty, MO 63028
Phone (314) 822-3122

9701 Landmark Parkway Dr
Ste 201
Saint Louis, MO 63127
Phone (314) 645-6247

1987 Highway a
Ste 210
Washington, MO 63090
Phone (636) 390-2007

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": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1710010947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 LANDMARK PARKWAY DR",
            "address_2": "STE 201",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631271665",
            "telephone_number": "314-843-3828",
            "fax_number": "314-843-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6565 N CHARLES ST",
            "address_2": "PPE SUITE 601",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046800",
            "telephone_number": "410-821-5151",
            "fax_number": "410-823-8309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETNER",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "HAD & SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2009001280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "THOMPSON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "HAD & SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; 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.