Individual provider Active NPI

Katlyn Plotzer, AU.D

  • Audiologist
  • Creve Coeur, MO
National Provider Identifier
1912513458
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2020016957 Issued in MO
Practice address
12380 Olive Blvd
Creve Coeur, MO 63141-6443
Phone
(314) 384-8088
Fax
(636) 238-4388
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 2020016957 MO Primary

Addresses

Primary practice location

12380 Olive Blvd
Creve Coeur, MO 63141-6443

Mailing address

12380 Olive Blvd
Creve Coeur, MO 63141-6443
Phone (314) 384-8088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200925001475 MO Practitioner - Qualified Audiologist 6608295597 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Dizziness and Balance Institute LLCGroup PAC ID 8224466701, 5 clinicians

Practice addresses (Care Compare)

14222 Ladue Rd
Chesterfield, MO 63017-3324
Phone (314) 384-8088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2020016957MOMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Dizziness and Balance Institute LLC Audiologist CurrentSince Jun 15, 2020 Accepting new patients
Sound Health Services P.C. PastSince Sep 27, 2020 Accepting new patients

Locations

14222 Ladue Rd
Chesterfield, MO 63017
Phone (314) 384-8088

12380 Olive Blvd
Saint Louis, MO 63141
Phone (314) 384-5454

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1912513458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12380 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416443",
            "telephone_number": "314-384-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12380 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416443",
            "telephone_number": "314-384-8088",
            "fax_number": "636-238-4388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOTZER",
        "first_name": "KATLYN",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MO",
            "license": "2020016957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.