Active NPI
Fawn E. Wujick, M.S.
- Audiologist
- Louisville, KY
National Provider Identifier
1023157401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 23002041A
- 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, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200209270 | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050921000514 | IN | Practitioner - Qualified Audiologist | 1052344470 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002041A | IN | MD | Audiologist |
| KY-0170 | KY | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merit Anesthesia PLLC | Current | Accepting new patients | |
| Hearmax, PLLC | Audiologist | Current | Accepting new patients |
| Primesource Healthcare Systems, Inc. | Audiologist | Past | Accepting new patients |
| Midwest Mobile Care Inc | Past | 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.
-
- Audiologist
- Louisville, KY
- NPI 1932248333
-
- Certified Registered Nurse Anesthetist
- Knoxville, TN
- NPI 1366624967
-
- Optometrist
- Franklin, IN
- NPI 1942432422
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.