Active NPI
Jan Marie Wirth, BC-HIS
- Hearing Instrument Specialist
- Manitowoc, WI
National Provider Identifier
1659547115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 1169
- Practice address
- 2525 Washington St
Manitowoc, WI 54220 - Phone
- (920) 682-4990
- Fax
- (920) 769-5131
- NPI assigned
- May 5, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | 1169-060 | WI | |
| Hearing Instrument Specialist | 237700000X | 1169 | WI | Primary |
Addresses
Primary practice location
2525 Washington St
Manitowoc, WI 54220
Mailing address
2525 Washington St.
Manitowoc, WI 54220
Phone (920) 682-4990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42834600 | Medicaid | WI |
Other names 1
- Jan Marie Frank
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 |
|---|---|---|---|
| 1169-060 | WI | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Abundant Life Hearing Health & More, Inc. | Hearing Instrument Specialist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Hearing Instrument Specialist
- Manitowoc, WI
- NPI 1205158904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489104000000",
"number": "1659547115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2525 WASHINGTON ST.",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "54220",
"telephone_number": "920-682-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2525 WASHINGTON ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "54220",
"telephone_number": "920-682-4990",
"fax_number": "920-769-5131"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIRTH",
"first_name": "JAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "BC-HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-05",
"last_updated": "2017-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WI",
"license": "1169-060",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WI",
"license": "1169",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42834600",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JAN",
"last_name": "FRANK",
"middle_name": "MARIE",
"credential": "BC-HIS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.