Individual provider Active NPI

Jessica Wilson, AU.D

  • Audiologist
  • Salem, OH
National Provider Identifier
1427807254
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A.02520 Issued in OH
Practice address
2388 Southeast Blvd # a
Salem, OH 44460-3418
Phone
(440) 372-0183
Fax
(330) 337-7130
NPI assigned
May 14, 2024
Last updated
Dec 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A.02520 OH Primary
Audiologist-Hearing Aid Fitter 237600000X A.02520 OH

Addresses

Primary practice location

2388 Southeast Blvd # a
Salem, OH 44460-3418

Mailing address

3837 Old Forge Rd
Rootstown, OH 44272-9673
Phone (330) 541-7148

Other identifiers 1

IdentifierTypeStateIssuer
0048525MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240620003115 OH Practitioner - Qualified Audiologist 5294278032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triad Health Services LLCGroup PAC ID 9032367917, 252 clinicians

Practice addresses (Care Compare)

2388 Southeast Blvd
Suite a
Salem, OH 44460-3418
Phone (330) 337-7159

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A.02520OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Triad Health Services, LLC CurrentSince Jun 10, 2024 Accepting new patients
Fifth Avenue Otolaryngologists, Inc. CurrentSince May 19, 2024 Accepting new patients
The Surgery Center at Southwoods, LLC PastSince Jun 10, 2024 Accepting new patients

Locations

2388 Southeast Blvd
#A
Salem, OH 44460
Phone (330) 337-7159

100 Debartolo Pl
Ste 200
Youngstown, OH 44512
Phone (330) 965-7828

7620 Southern Blvd
Ste 1
Youngstown, OH 44512
Phone (330) 629-2144

7629 Market St
Ste 250
Youngstown, OH 44512
Phone (330) 729-9480

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1427807254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3837 OLD FORGE RD",
            "city": "ROOTSTOWN",
            "state": "OH",
            "postal_code": "442729673",
            "telephone_number": "330-541-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2388 SOUTHEAST BLVD # A",
            "city": "SALEM",
            "state": "OH",
            "postal_code": "444603418",
            "telephone_number": "440-372-0183",
            "fax_number": "330-337-7130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "credential": "AU.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A.02520",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OH",
            "license": "A.02520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0048525",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.