Active NPI
Lisa Wear Wilcox, AUD, CCC-A
- Audiologist
- San Antonio, TX
National Provider Identifier
1285785485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- A 01362
- Practice address
- 4502 Medical Dr
Hearing and Balance Center
San Antonio, TX 78229-4402 - Phone
- (210) 358-4583
- Fax
- (210) 358-2654
- NPI assigned
- Jan 15, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | A 01362 | OH | Primary |
| Audiologist | 231H00000X | 80134 | TX | |
| Audiologist-Hearing Aid Fitter | 237600000X | 80134 | TX |
Addresses
Primary practice location
4502 Medical Dr
Hearing and Balance Center
San Antonio, TX 78229-4402
Mailing address
4502 Medical Dr
Hearing and Balance Center
San Antonio, TX 78229-4402
Phone (210) 358-4583
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00434163 | Other | OH | RRMC |
| PENDING | Other | OH | AETNA |
| 5187350 | Medicaid | MI | |
| 04709 | Other | OH | PARAMOUNT |
| 296609964-002 | Other | OH | MMOH |
| 296609964-001 | Other | OH | MMOH |
| PENDING | Other | OH | HEALTH NET TRICARE |
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 |
|---|---|---|---|
| 80134 | TX | MD | Professional Counselor |
| A 01362 | OH | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249948800000",
"number": "1285785485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"address_2": "HEARING AND BALANCE CENTER",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4583",
"fax_number": "210-358-2654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4502 MEDICAL DR",
"address_2": "HEARING AND BALANCE CENTER",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782294402",
"telephone_number": "210-358-4583",
"fax_number": "210-358-2654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILCOX",
"first_name": "LISA",
"middle_name": "WEAR",
"credential": "AUD, CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2009-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "OH",
"license": "A 01362",
"primary": true
},
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "80134",
"primary": false
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "TX",
"license": "80134",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RRMC",
"identifier": "P00434163",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "PENDING",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5187350",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PARAMOUNT",
"identifier": "04709",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMOH",
"identifier": "296609964-002",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MMOH",
"identifier": "296609964-001",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH NET TRICARE",
"identifier": "PENDING",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.