DR. MICHELLE JEANNE BOTKO (NPI# 1558485540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558485540 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE JEANNE BOTKO |
| Credential | M.A. |
| Practice Address |
1560 Beam Ave Ste 101 Maplewood MN 55109-1191 |
| Mailing Address |
8800 Se Sunnyside Rd Ste 300n Clackamas OR 97015-5703 |
| Practice Telephone | 6517777837 |
| Practice Fax Number | 6517778754 |
| Mailing Telephone | 2812862999 |
| Mailing Fax Number | 6126074893 |
| Enumeration Date | 2007-03-17 |
| Last Update Date | 2018-01-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 231H00000X | Audiologist | 6249 | MN | Speech, Language and Hearing Service Providers |
| N | 237600000X | Audiologist-Hearing Aid Fitter | MN | Speech, Language and Hearing Service Providers | |
| N | 237700000X | Hearing Instrument Specialist | MN | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | MEDICARE | 640000549 | 01 |
| Street Address |
1560 BEAM AVE STE 101 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558417543 | Northland Hearing Centers, Inc | Hearing Instrument Specialist | 1560 Beam Ave Ste 101, Maplewood, MN 55109-1191 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 231H00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Audiologist |
| (1) A specialist in evaluation, habilitation and rehabilitation of those whose communication disorders center in whole or in part in hearing function. Audiologists are autonomous professionals who identify, assess, and manage disorders of the auditory, balance and other neural systems. Audiologists provide audiological (aural) rehabilitation to children and adults across the entire age span. Audiologists select, fit and dispense amplification systems such as hearing aids and related devices. (2) An audiologist is a person qualified by a master’s degree in audiology, licensed by the state, where applicable, and practicing within the scope of that license. Audiologists evaluate and treat patients with impaired hearing. They plan, direct and conduct rehabilitative programs with audiotry substitutional devises (hearing aids) and other therapy. |
| Notes: Source: (1) American Speech-Language-Hearing Association, (1996, Spring) Scope of practice in Audiology, p. 2 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588822019 | Ralph Moscarella | Audiologist | 1984 Springfield Ave, Maplewood, NJ 07040-3437 | 2008-05-31 |
| 1336354794 | Irene N Okeke | Audiologist | 1984 Springfield Avenue, 1st Floor, Maplewood, NJ 07040 | 2007-05-11 |
| 1245846542 | Alanna Marie Wallerstein | Audiologist | 2945 Hazelwood St Ste 200, Maplewood, MN 55109-1243 | 2020-09-22 |
| 1255522769 | Jamie K Kirchoff | Audiologist | 1675 Beam Ave, Suite 200, Maplewood, MN 55109-1172 | 2007-08-08 |
| 1760547269 | Amanda Jo Meixelsperger | Audiologist | 1675 Beam Ave, Suite 200, Maplewood, MN 55109-1172 | 2006-12-26 |
| 1730125162 | Anne Katherine Zowin | Audiologist | 1675 Beam Ave, 200, Maplewood, MN 55109 | 2006-06-22 |
| 1376589630 | Kelly Ann Veit | Audiologist | 1675 Beam Ave, #200, Maplewood, MN 55109 | 2006-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043839715 | Thomas J Tedeschi | Audiologist | 150 S 5th St Ste 2300, Minneapolis, MN 55402-4223 | 2020-04-13 |
| 1902435514 | Robert Lang | Audiologist | 1597 Park Ave, White Bear Lake, MN 55110-3704 | 2020-04-06 |
| 1528625290 | Kara Rae Balken | Audiologist | 7300 France Ave S Ste 101, Edina, MN 55435-4525 | 2019-05-28 |
| 1538724612 | Elizabeth Mary Butler | Audiologist | 1155 E County Road E, Ste 100, Minneapolis, MN 55110-5191 | 2019-05-05 |
| 1417422445 | Joelle Peterson | Audiologist | 12925 16th Ave N, Plymouth, MN 55441-4560 | 2018-10-05 |
| 1275028227 | Karen Brennhofer | Audiologist | 2200 Nw 26th St Apt 309, Owatonna, MN 55060 | 2018-06-22 |
| 1700313681 | Hannah Catherine Erickson Herd | Audiologist | 701 25th Ave S Fl 2, Minneapolis, MN 55454 | 2017-05-22 |
| 1245780121 | Rachel Lauren Marston | Audiologist | 7745 2nd Ave S., Suite 1, Richfield, MN 55423 | 2016-10-04 |
| 1184178956 | Eric R Barrett | Audiologist | Starkey Center for Excellence, 6700 Washington Ave S, Eden Prairie, MN 55344 | 2016-08-10 |
| 1457711327 | Reynolds Audiology LLC | Audiologist | 2155 Woodlane Drive, Suite 103, Woodbury, MN 55125-3049 | 2016-03-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.