Individual provider Active NPI

Jennifer L Ploch, AUD

  • Audiologist
  • Springfield, MO
National Provider Identifier
1750345336
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2021008775 Issued in MO
Practice address
1229 E Seminole St Ste 520
Springfield, MO 65804-2227
Phone
(417) 820-5071
NPI assigned
Apr 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 90156 WI
Audiologist 231H00000X 2021008775 MO Primary

Addresses

Primary practice location

1229 E Seminole St Ste 520
Springfield, MO 65804-2227

Mailing address

1229 E Seminole St Ste 520
Springfield, MO 65804-2227
Phone (417) 820-5071

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210426000765 MO Practitioner - Qualified Audiologist 4486778891 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1229 E Seminole St
Springfield, MO 65804-2227
Phone (417) 820-5750

448 State Hwy 248
Suite 180
Branson, MO 65616-3725
Phone (800) 658-0454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
90156WIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Apr 19, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 19, 2021 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Apr 19, 2021 Accepting new patients

Locations

448 State Highway 248
Ste 180
Branson, MO 65616
Phone (417) 820-2064

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1750345336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST STE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 E SEMINOLE ST STE 520",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042227",
            "telephone_number": "417-820-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOCH",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "90156",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2021008775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.