Individual provider Active NPI

Natasha Olivia Rene Wynn, AU.D.

  • Audiologist
  • Milford, DE
National Provider Identifier
1659928976
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
02-0000250 Issued in DE
Practice address
101 Wellness Way Ste 300
Milford, DE 19963-4366
Phone
(302) 393-5009
Fax
(302) 424-9211
NPI assigned
Aug 21, 2019
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 02-0000250 DE Primary

Addresses

Primary practice location

101 Wellness Way Ste 300
Milford, DE 19963-4366

Mailing address

226 Mariners Way
Bear, DE 19701-2292

Other practice location 1

826 S Governors Ave
Dover, DE 19904-4107
Phone (302) 674-3752

Other names 1

  • Dr. Natasha Olivia Rene Gaston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200309000340 DE Practitioner - Qualified Audiologist 8628406576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayhealth Medical Center, IncGroup PAC ID 1658364740, 399 clinicians

Practice addresses (Care Compare)

826 S Governors Ave
Bayhealth Ear Nose Throat
Dover, DE 19904-4107
Phone (302) 674-3752

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02-0000250DEMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayhealth Medical Center, Inc CurrentSince Jul 1, 2022 Accepting new patients
Bayhealth Medical Center, Inc CurrentSince Jul 1, 2022 Accepting new patients

Locations

640 S State St
Dover, DE 19901
Phone (302) 744-4700

640 S State St
#3055
Dover, DE 19901
Phone (302) 480-1688

826 S Governors Ave
Dover, DE 19904
Phone (302) 674-3752

101 Wellness Way
Ste 300
Milford, DE 19963
Phone (302) 393-5009

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1659928976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 MARINERS WAY",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197012292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WELLNESS WAY STE 300",
            "city": "MILFORD",
            "state": "DE",
            "postal_code": "199634366",
            "telephone_number": "302-393-5009",
            "fax_number": "302-424-9211"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "826 S Governors Ave",
            "address_purpose": "LOCATION",
            "city": "Dover",
            "state": "DE",
            "postal_code": "199044107",
            "country_code": "US",
            "telephone_number": "302-674-3752",
            "fax_number": "302-674-8521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WYNN",
        "first_name": "NATASHA",
        "middle_name": "OLIVIA RENE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "DE",
            "license": "02-0000250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NATASHA",
            "last_name": "GASTON",
            "middle_name": "OLIVIA RENE",
            "prefix": "DR.",
            "credential": "AU.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milford, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.