Active NPI
Amy L Wilder, HAS, BC-HIS
- Hearing Instrument Specialist
- Port Saint Lucie, FL
National Provider Identifier
1649732009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- AS5334
- Practice address
- 10929 S US Highway 1
Port Saint Lucie, FL 34952-6417 - Phone
- (772) 337-2526
- Fax
- (772) 337-2589
- NPI assigned
- Apr 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | AS5334 | FL | Primary |
Addresses
Primary practice location
10929 S US Highway 1
Port Saint Lucie, FL 34952-6417
Mailing address
10929 S US Highway 1
Port Saint Lucie, FL 34952-6417
Phone (772) 337-2526
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AS5334 | FL | MD | Hearing Instrument Specialist |
Practice roles
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": "1554336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1649732009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10929 S US HIGHWAY 1",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349526417",
"telephone_number": "772-337-2526",
"fax_number": "772-337-2589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10929 S US HIGHWAY 1",
"city": "PORT SAINT LUCIE",
"state": "FL",
"postal_code": "349526417",
"telephone_number": "772-337-2526",
"fax_number": "772-337-2589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "AMY",
"middle_name": "L",
"credential": "HAS, BC-HIS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-04-04",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Hearing Instrument Specialist",
"state": "FL",
"license": "AS5334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Port Saint Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.