Active NPI
Emily Wielert
- Audiologist
- Jbsa Lackland, TX
National Provider Identifier
1275911166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- AUD004157
- Practice address
- 1100 Wilford Loop
BLDG 4554, Wilford Hall Ambulatory Surgical Center
Jbsa Lackland, TX 78236 - Phone
- (210) 292-5339
- NPI assigned
- May 11, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1152A | AL | |
| Audiologist | 231H00000X | AUD004157 | GA | Primary |
Addresses
Primary practice location
1100 Wilford Loop
BLDG 4554, Wilford Hall Ambulatory Surgical Center
Jbsa Lackland, TX 78236
Mailing address
1100 Wilford Loop
BLDG 4554, Wilford Hall Ambulatory Surgical Center
Jbsa Lackland, TX 78236
Phone (210) 292-5339
Other practice location 1
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-2020
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1152A | AL | MD | Audiologist |
| AUD004157 | GA | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750896000000",
"number": "1275911166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 WILFORD LOOP",
"address_2": "BLDG 4554, WILFORD HALL AMBULATORY SURGICAL CENTER",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "78236",
"telephone_number": "210-292-5339"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 WILFORD LOOP",
"address_2": "BLDG 4554, WILFORD HALL AMBULATORY SURGICAL CENTER",
"city": "JBSA LACKLAND",
"state": "TX",
"postal_code": "78236",
"telephone_number": "210-292-5339"
}
],
"practiceLocations": [
{
"address_1": "4700 Las Vegas Blvd N",
"address_purpose": "LOCATION",
"city": "Nellis AFB",
"state": "NV",
"postal_code": "891916600",
"country_code": "US",
"telephone_number": "702-653-2020",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIELERT",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-11",
"last_updated": "2025-06-26",
"certification_date": "2025-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "AL",
"license": "1152A",
"primary": false
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "GA",
"license": "AUD004157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jbsa Lackland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.