Individual provider Active NPI

Olga Von Hartze Perkins

  • Hearing Instrument Specialist
  • Fort Myers, FL
National Provider Identifier
1669411716
Registry record updated Feb 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
AS5494 Issued in FL
Practice address
12381 S Cleveland Ave Ste 405
Fort Myers, FL 33907-3893
Phone
(239) 461-9321
Fax
(239) 461-5354
NPI assigned
Jun 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X AS5494 FL Primary
Hearing Instrument Specialist 237700000X 02453 MD

Addresses

Primary practice location

12381 S Cleveland Ave Ste 405
Fort Myers, FL 33907-3893

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380

Other names 1

  • Olga Von Hartze Wageman Former name

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

LicenseStateTypeSpecialty
AS5494FLMDHearing Instrument Specialist
02453MDMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing Inc Hearing Instrument Specialist PastSince Feb 26, 2023 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.

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1669411716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047940",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12381 S CLEVELAND AVE STE 405",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073893",
            "telephone_number": "239-461-9321",
            "fax_number": "239-461-5354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "OLGA",
        "middle_name": "VON HARTZE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS5494",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "MD",
            "license": "02453",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLGA",
            "last_name": "WAGEMAN",
            "middle_name": "VON HARTZE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.