Individual provider Active NPI

Kelly Kiley Knighten, AU.D., CCC-A

  • Audiologist
  • Valley Park, MO
National Provider Identifier
1710147343
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2014036556 Issued in MO
Practice address
912 Meramec Station Rd Ste F
Valley Park, MO 63088-2045
Phone
(636) 825-9999
NPI assigned
Jun 17, 2008
Last updated
May 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2014036556 MO Primary

Addresses

Primary practice location

912 Meramec Station Rd Ste F
Valley Park, MO 63088-2045

Mailing address

912 Meramec Station Rd Ste F
Valley Park, MO 63088-2045
Phone (636) 825-9999

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230608000877 MO Practitioner - Qualified Audiologist 3870669674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
At Still Un of HLTH Sciences, Col of Osteo Med, Mesa, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

912 Meramec Station Rd
Suite F
Valley Park, MO 63088-2045
Phone (636) 825-9999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014036556MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Audiology Associates, LLC Audiologist CurrentSince Jun 5, 2023 Accepting new patients
Audists, Inc Audiologist-Hearing Aid Fitter Past Accepting new patients

Locations

912 Meramec Station Rd
Ste F
Valley Park, MO 63088
Phone (618) 939-6861

Organizations & group practices 2

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1710147343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 MERAMEC STATION RD STE F",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882045",
            "telephone_number": "636-825-9999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 MERAMEC STATION RD STE F",
            "city": "VALLEY PARK",
            "state": "MO",
            "postal_code": "630882045",
            "telephone_number": "636-825-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHTEN",
        "first_name": "KELLY",
        "middle_name": "KILEY",
        "name_prefix": "Ms.",
        "credential": "AU.D., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-17",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2014036556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Park, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.