Sharon Lynne Jividen, MS CCCA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

A0203 Issued in WV

Practice address

508 New Hope Road
Suite #19
Princeton, WV 24740-2272

Phone

(304) 487-2487

Fax

(304) 431-3367

NPI assigned

Mar 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Sharon Lynne Heffinger Former name

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Princeton Audiology Clinic IncGroup PAC ID 1052300357, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Princeton Audiology Clinic, Inc.,

  • Hearing Aid Equipment
  • Princeton, WV
  • NPI 1073580817
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370390400000",
    "number": "1609843440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE ROAD",
            "address_2": "SUITE #19",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402272",
            "telephone_number": "304-487-2487",
            "fax_number": "304-431-3367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 NEW HOPE ROAD",
            "address_2": "SUITE #19",
            "city": "PRINCETON",
            "state": "WV",
            "postal_code": "247402272",
            "telephone_number": "304-487-2487",
            "fax_number": "304-431-3367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIVIDEN",
        "first_name": "SHARON",
        "middle_name": "LYNNE",
        "credential": "MS CCCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2013-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201000469",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2101000721",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WV",
            "license": "A0203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001841",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA MEDICARE PTAN NUMBER PCTN OFFICE",
            "identifier": "0602472",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA MEDICARE PTAN NUMBER BLFD OFFICE",
            "identifier": "0602473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "HEFFINGER",
            "middle_name": "LYNNE",
            "credential": "MS CCCA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Trista Jenkins
• Jacob Jennelle
• Rachel Jennelle, PRSS
• Amber Jennings
• Abigail Jeske
• Johnnie Johns
• Shannon Nickole Johns, FNP-C
• Beth Johnson
• Brandon Johnson, PRSS
• Donna Faye Johnson

• Audiologist in Princeton, WV
• Providers in Princeton, WV by specialty
• Audiologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; 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.