Individual provider Active NPI

Wanda Kay Crawford, MS CCCA

  • Audiologist
  • Hendersonville, NC
National Provider Identifier
1144355488
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
14535 Issued in NC
Practice address
1727 Brevard Rd
Hendersonville, NC 28791-3259
Phone
(828) 696-8272
Fax
(828) 696-8790
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 307156 WI
Audiologist 231H00000X 7961 MN
Audiologist 231H00000X 14535 NC Primary

Addresses

Primary practice location

1727 Brevard Rd
Hendersonville, NC 28791-3259

Mailing address

411 Stageline Rd # 290
Hudson, WI 54016-7848
Phone (715) 531-6710

Other practice location 1

411 Stageline Rd # 290
Hudson, WI 54016-7848
Phone (715) 531-6710

Other practice location 2

400 8th St
North Wilkesboro, NC 28659-4130
Phone (336) 838-9530

Other practice location 3

7270 Forestview Ln N Ste 160
Maple Grove, MN 55369-5698
Phone (320) 252-0094

Other identifiers 2

IdentifierTypeStateIssuer
1144355488MedicaidMN
41148500MedicaidWI

Other names 1

  • Mrs. Wanda Kay Klevgard Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211012000633 NC Practitioner - Qualified Audiologist 7416031687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Hearing and Tinnitus PCGroup PAC ID 3971872854, 4 clinicians

Practice addresses (Care Compare)

217 W Park Ave
Mooresville, NC 28115-2243
Phone (704) 872-1670

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
7961MNMDPhysical Therapist
307156WIMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Hearing and Tinnitus, PC CurrentSince Sep 30, 2021 Accepting new patients
Hearing Services & Hearing Aid Center, Inc. Past Accepting new patients
Mark a. Kenzik, M.a., Inc Audiologist PastSince Sep 12, 2021 Accepting new patients

Locations

400 8th St
North Wilkesboro, NC 28659
Phone (336) 838-9530

703 Bryant St
Statesville, NC 28677
Phone (704) 872-1670

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1144355488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 STAGELINE RD # 290",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540167848",
            "telephone_number": "715-531-6710",
            "fax_number": "651-888-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 BREVARD RD",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913259",
            "telephone_number": "828-696-8272",
            "fax_number": "828-696-8790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "411 Stageline Rd # 290",
            "address_purpose": "LOCATION",
            "city": "Hudson",
            "state": "WI",
            "postal_code": "540167848",
            "country_code": "US",
            "telephone_number": "715-531-6710",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 8th St",
            "address_purpose": "LOCATION",
            "city": "North Wilkesboro",
            "state": "NC",
            "postal_code": "286594130",
            "country_code": "US",
            "telephone_number": "336-838-9530",
            "fax_number": "704-878-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7270 Forestview Ln N Ste 160",
            "address_purpose": "LOCATION",
            "city": "Maple Grove",
            "state": "MN",
            "postal_code": "553695698",
            "country_code": "US",
            "telephone_number": "320-252-0094",
            "fax_number": "651-888-7801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRAWFORD",
        "first_name": "WANDA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MS CCCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WI",
            "license": "307156",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MN",
            "license": "7961",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NC",
            "license": "14535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144355488",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41148500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "KLEVGARD",
            "middle_name": "KAY",
            "prefix": "MRS.",
            "credential": "MS CCCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.