Active NPI
Patricia Anne Wild, MA
- Audiologist
- Durham, NC
National Provider Identifier
1528231297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 5660
- Practice address
- 4102 N Roxboro Rd
Durham, NC 27704-2122 - Phone
- (919) 595-2000
- Fax
- (919) 595-2190
- NPI assigned
- Apr 2, 2008
- Last updated
- Jun 5, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 5660 | NC | Primary |
Addresses
Primary practice location
4102 N Roxboro Rd
Durham, NC 27704-2122
Mailing address
4102 N Roxboro Rd
Durham, NC 27704-2122
Phone (919) 595-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081006000504 | NC | Practitioner - Qualified Audiologist | 2860560703 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5660 | NC | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685923200000",
"number": "1528231297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4102 N ROXBORO RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042122",
"telephone_number": "919-595-2000",
"fax_number": "919-595-2190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4102 N ROXBORO RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277042122",
"telephone_number": "919-595-2000",
"fax_number": "919-595-2190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILD",
"first_name": "PATRICIA",
"middle_name": "ANNE",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-04-02",
"last_updated": "2023-06-05",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NC",
"license": "5660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; 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.