Individual provider Active NPI

Krisjeana M Vernon, M.S.

  • Audiologist
  • Saint Peters, MO
National Provider Identifier
1780841379
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2007007757 Issued in MO
Practice address
4790 Executive Centre Parkway
St. Peters, MO 63376
Phone
(636) 441-3100
Fax
(636) 926-8519
NPI assigned
May 21, 2008
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2007007757 MO Primary

Addresses

Primary practice location

4790 Executive Centre Parkway
St. Peters, MO 63376

Mailing address

4790 Executive Centre Parkway
St. Peters, MO 63376
Phone (636) 441-3100

Other names 1

  • Krisjeana M Ballard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100324000125 MO Practitioner - Qualified Audiologist 1153456587 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, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Centre, PCGroup PAC ID 5597839878, 12 clinicians

Practice addresses (Care Compare)

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Organizations & group practices 1

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": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265155200000",
    "number": "1780841379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PARKWAY",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-441-3100",
            "fax_number": "636-926-8519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PARKWAY",
            "city": "ST. PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-441-3100",
            "fax_number": "636-926-8519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERNON",
        "first_name": "KRISJEANA",
        "middle_name": "M",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2007007757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISJEANA",
            "last_name": "BALLARD",
            "middle_name": "M",
            "credential": "M.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; 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.