Ann Depaolo Wietsma, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2201001146 Issued in VA

Practice address

45 N Main St
Kilmarnock, VA 22482-8501

Phone

(804) 435-0758

Fax

(804) 435-7226

NPI assigned

Mar 16, 2006

Last updated

Apr 14, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Ann Depaolo Professional name

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Audiology Offices LLCGroup PAC ID 7810065034, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• The Audiology Offices LLC

  • Audiologist
  • Kilmarnock, VA
  • NPI 1972716066
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1598734097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1911",
            "address_2": "45 N MAIN STREET",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224821911",
            "telephone_number": "804-435-0758",
            "fax_number": "804-435-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N MAIN ST",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224828501",
            "telephone_number": "804-435-0758",
            "fax_number": "804-435-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIETSMA",
        "first_name": "ANN",
        "middle_name": "DEPAOLO",
        "name_prefix": "Ms.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN",
            "last_name": "DEPAOLO",
            "prefix": "MS.",
            "credential": "AU.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Audiologist in Kilmarnock, VA
• Providers in Kilmarnock, VA by specialty
• Audiologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; 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.