Active NPI
Gloria Wilson
- Audiologist
- Barbourville, KY
National Provider Identifier
1104962778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 0206
- Practice address
- 110 Johnson LN
Barbourville, KY 40906-1321 - Phone
- (606) 546-5109
- Fax
- (606) 546-4199
- NPI assigned
- Jan 30, 2007
- Last updated
- Aug 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 0206 | KY | Primary |
Addresses
Primary practice location
110 Johnson LN
Barbourville, KY 40906-1321
Mailing address
371 Ky 225
Barbourville, KY 40906-7758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0206 | KY | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219363200000",
"number": "1104962778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "371 KY 225",
"city": "BARBOURVILLE",
"state": "KY",
"postal_code": "409067758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 JOHNSON LN",
"city": "BARBOURVILLE",
"state": "KY",
"postal_code": "409061321",
"telephone_number": "606-546-5109",
"fax_number": "606-546-4199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "GLORIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-30",
"last_updated": "2008-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "KY",
"license": "0206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Barbourville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.