Individual provider Active NPI

Fawn E. Wujick, M.S.

  • Audiologist
  • Louisville, KY
National Provider Identifier
1023157401
Registry record updated Nov 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
23002041A Issued in IN
Practice address
2308 Sycamore Ave
Louisville, KY 40206-2421
Phone
(502) 693-1449
Fax
(188) 851-1026
NPI assigned
Feb 5, 2007
Last updated
Nov 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X KY-0170 KY
Audiologist 231H00000X 23002041A IN Primary

Addresses

Primary practice location

2308 Sycamore Ave
Louisville, KY 40206-2421

Mailing address

2308 Sycamore Ave
Louisville, KY 40206-2421
Phone (502) 693-1449

Other identifiers 1

IdentifierTypeStateIssuer
200209270MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050921000514 IN Practitioner - Qualified Audiologist 1052344470

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23002041AINMDAudiologist
KY-0170KYMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Merit Anesthesia PLLC CurrentSince Apr 1, 2020 Accepting new patients
Hearmax, PLLC Audiologist CurrentSince Jun 29, 2005 Accepting new patients
Primesource Healthcare Systems, Inc. Audiologist Past Accepting new patients
Midwest Mobile Care Inc PastSince Sep 3, 2020 Accepting new patients

Locations

110 N Jackson St
Franklin, IN 46131
Phone (317) 346-4107

108 W Daisy Ln
New Albany, IN 47150
Phone (812) 945-3557

2944 Breckenridge Ln
Louisville, KY 40220
Phone (502) 995-5525

Organizations & group practices 4

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732406400000",
    "number": "1023157401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 SYCAMORE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062421",
            "telephone_number": "502-693-1449",
            "fax_number": "188-851-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2308 SYCAMORE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402062421",
            "telephone_number": "502-693-1449",
            "fax_number": "188-851-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUJICK",
        "first_name": "FAWN",
        "middle_name": "E.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "KY-0170",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "IN",
            "license": "23002041A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200209270",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.