Jennifer L Wagner, AU.D.
Individual provider Active NPI Audiologist · Bluffton, IN
NPI 1679767396 · NPPES record last updated Oct 15, 2020
Key facts
- NPI
- 1679767396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Audiologist 231H00000X
- License
- 23002421A (IN)
- Practice address
- 2035 Commerce Dr Ste 208
Bluffton, IN 46714-9295 - Phone
- (260) 706-2558
- Fax
- (260) 435-1595
- NPI assigned
- Sep 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23002421A | IN | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| J. Wagner, LLC | Audiologist | Current | Accepting new patients |
| Carter Hearing Clinics LLC | Audiologist | Past | Accepting new patients |
Locations
2035 Commerce Dr
Ste 201
Bluffton, IN 46714
Phone (260) 706-2558
832 S 11th St
Decatur, IN 46733
Phone (260) 706-2558
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 23002421A | IN | Yes |
Addresses
Primary practice location
2035 Commerce Dr Ste 208
Bluffton, IN 46714-9295
Mailing address
2035 Commerce Dr Ste 208
Bluffton, IN 46714-9295
Phone (260) 706-2558
Other practice location 1
832 S 11th St
Decatur, IN 46733-3402
Phone (260) 706-2558
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200874560 | Medicaid | IN |
Other names
- Jennifer L Hill
Other providers in Bluffton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.