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NPI Code Detail

MEDICARE: KELLY N SPILLER AU.D.

MEDICARE:   KELLY N SPILLER  AU.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1231H00000XAudiologist1998KS
2231H00000XAudiologist2004021609MO
3237700000XHearing Instrument Specialist1328KS
4237600000XAudiologist-Hearing Aid Fitter2004021609MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
142053021OTHERMOBCBS OF KC
242053031OTHERMOBCBS OF KC
342053041OTHERKSBCBS OF KC
442053051OTHERMOBCBS OF KC

General Provider Information

NPI Number : 1073707352
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY N SPILLER AU.D.
Provider Business Mailing Address
First Line : 5101 COLLEGE BLVD
Second Line :
City : LEAWOOD
State : KS
Zip : 66211-1614
Country : US
Telephone Number : 816-331-4327
Fax Number : 816-331-4344
Provider Business Practice Location Address
First Line : 112 CONGRESS ST
Second Line :
City : BELTON
State : MO
Zip : 64012-2400
Country : US
Telephone Number : 816-331-4327
Fax Number : 816-331-4344
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2007
Last Update Date : 08/01/2024

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