Benjamin Andrew Pettit, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2016026739 Issued in MO

Practice address

915 S Baltimore St
Kirksville, MO 63501-4027

Phone

(660) 956-9156

Fax

(660) 956-9151

NPI assigned

Aug 1, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hearken Hearing & Audiology LLC

  • Audiologist
  • Kirksville, MO
  • NPI 1710498019
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470009600000",
    "number": "1780137240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 S BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014027",
            "telephone_number": "660-956-9156",
            "fax_number": "660-956-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 S BALTIMORE ST",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014027",
            "telephone_number": "660-956-9156",
            "fax_number": "660-956-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "BENJAMIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-01",
        "last_updated": "2016-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2016026739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Xavier Pereira
• Katie Peters, LPC
• Lorrie Peters
• Melissa C Peters, PTA
• Tysen J Petre, D.O.
• Douglas Gene Petty, RPH
• Thao Pham, DO
• Max J Phillips, LCSW
• Ronald Leland Phillips, MD
• Ricardo Michael Phipps, PH.D, LCPC, LPC, NCC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2016; 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.