Individual provider Active NPI

Olivia Pergler Black, AUD

  • Audiologist
  • Grand Rapids, MI
National Provider Identifier
1689582579
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
Practice address
2020 Raybrook St SE Ste E
Grand Rapids, MI 49546-7717
Phone
(616) 940-3313
NPI assigned
Aug 31, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X Primary

Addresses

Primary practice location

2020 Raybrook St SE Ste E
Grand Rapids, MI 49546-7717

Mailing address

2020 Raybrook St SE Ste E
Grand Rapids, MI 49546-7717

Other practice location 1

523 Wilson Ave NW
Walker, MI 49534-3455
Phone (616) 914-1054

Other practice location 2

4555 Wilson Ave SW Ste 3
Grandville, MI 49418-2370
Phone (616) 538-8220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1689582579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 RAYBROOK ST SE STE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467717",
            "telephone_number": "616-940-3313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "523 Wilson Ave NW",
            "address_purpose": "LOCATION",
            "city": "Walker",
            "state": "MI",
            "postal_code": "495343455",
            "country_code": "US",
            "telephone_number": "616-914-1054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4555 Wilson Ave SW Ste 3",
            "address_purpose": "LOCATION",
            "city": "Grandville",
            "state": "MI",
            "postal_code": "494182370",
            "country_code": "US",
            "telephone_number": "616-538-8220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "OLIVIA",
        "middle_name": "PERGLER",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-31",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.