Jessica Lynn Wagner, AU.D

Primary specialty

AudiologistTaxonomy code 231H00000X

License

41YA00104600 Issued in NJ

Practice address

140 Park Avenue
Audiology
Florham Park, NJ 07932

Phone

(973) 404-9890

Fax

(973) 267-0024

NPI assigned

May 27, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• The Milton S. Hershey Medical Center

  • Community/Retail Pharmacy
  • Hershey, PA
  • NPI 1902283799
  NPD (past)
• The Milton S. Hershey Medical Center Physician Group

  • Audiologist
  • Hershey, PA
  • NPI 1982228185
  NPD (past)

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1013365246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DIAMOND HILL RD",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079222104",
            "telephone_number": "908-273-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PARK AVENUE",
            "address_2": "AUDIOLOGY",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "07932",
            "telephone_number": "973-404-9890",
            "fax_number": "973-267-0024"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "153 Brodhead Rd",
            "address_purpose": "LOCATION",
            "city": "Bethlehem",
            "state": "PA",
            "postal_code": "180178931",
            "country_code": "US",
            "telephone_number": "484-526-3201",
            "fax_number": "484-526-3768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr.",
            "address_2": "Suite 400",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "17033",
            "country_code": "US",
            "telephone_number": "717-531-6822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "PA",
            "license": null,
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00104600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Florham Park, NJ
• Providers in Florham Park, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.