Alicia Ellen Wooten, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2014035188 Issued in MO

Practice address

620 Walton Dr
Farmington, MO 63640-1935

Phone

(573) 756-0500

Fax

(573) 756-0505

NPI assigned

Nov 11, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Alicia Ellen White Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1415664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1760888218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WALTON DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401935",
            "telephone_number": "573-756-0500",
            "fax_number": "573-756-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 WALTON DR",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401935",
            "telephone_number": "573-756-0500",
            "fax_number": "573-756-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOTEN",
        "first_name": "ALICIA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-11",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2014035188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WHITE",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "AU,D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Audiologist in Farmington, MO
• Providers in Farmington, MO by specialty
• Audiologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.