Individual provider Active NPI

Pamela Shattuck Nelson, AU.D.

  • Audiologist
  • Saint Joseph, MO
National Provider Identifier
1730333774
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2012034143 Issued in MO
Practice address
2227 N Belt Hwy
Saint Joseph, MO 64506-2205
Phone
(816) 233-0022
NPI assigned
Nov 4, 2008
Last updated
Oct 9, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2012034143 MO Primary
Audiologist 231H00000X 2650 CA
Audiologist-Hearing Aid Fitter 237600000X NU

Addresses

Primary practice location

2227 N Belt Hwy
Saint Joseph, MO 64506-2205

Mailing address

2227 N Belt Hwy
Saint Joseph, MO 64506-2205
Phone (816) 233-0022

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150307000232 MO Practitioner - Qualified Audiologist 0042535734 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Quality Hearing and Audiology Center LLCGroup PAC ID 9133444821, 2 clinicians

Practice addresses (Care Compare)

2227 N Belt Hwy
Saint Joseph, MO 64506-2205
Phone (816) 233-0022

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2012034143MOMDAudiologist
2650CAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Hearing and Audiology Center LLC Audiologist CurrentSince Oct 10, 2014 Accepting new patients

Locations

2227 N Belt Hwy
Saint Joseph, MO 64506
Phone (816) 233-0022

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": "1225756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1730333774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2227 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062205",
            "telephone_number": "816-233-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2227 N BELT HWY",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645062205",
            "telephone_number": "816-233-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "PAMELA",
        "middle_name": "SHATTUCK",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-04",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2012034143",
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "2650",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.