Individual provider Active NPI

Jacqueline Susanne Wiegers, AU.D.

  • Audiologist
  • Highland, MI
National Provider Identifier
1336588359
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1601000645 Issued in MI
Practice address
222 W Highland Rd
Highland, MI 48357-4504
Phone
(248) 889-7600
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 1601000645 MI Primary

Addresses

Primary practice location

222 W Highland Rd
Highland, MI 48357-4504

Mailing address

743 Coachman Dr
Apt. 3
Troy, MI 48083-1539
Phone (248) 376-8384

Other names 1

  • Dr. Jacqueline Susanne Wiegand Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130904000077 MI Practitioner - Qualified Audiologist 8123261567 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Richard a. Wandzel, DO PC CurrentSince Jul 1, 2013 Accepting new patients
Oakland Hearing CurrentSince Jun 1, 2019 Accepting new patients

Locations

222 W Highland Rd
Highland, MI 48357
Phone (248) 624-9900

5390 Highland Rd
Ste 1
Waterford, MI 48327
Phone (248) 673-8000

5390 Highland Rd
Waterford, MI 48327

Organizations & group practices 2

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": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1336588359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 COACHMAN DR",
            "address_2": "APT. 3",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831539",
            "telephone_number": "248-376-8384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W HIGHLAND RD",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483574504",
            "telephone_number": "248-889-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGERS",
        "first_name": "JACQUELINE",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MI",
            "license": "1601000645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQUELINE",
            "last_name": "WIEGAND",
            "middle_name": "SUSANNE",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Highland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.

Verify at the official NPI Registry.