Active NPI
Sharon Wicker, AU.D.
- Audiologist
- Leesburg, VA
National Provider Identifier
1720028087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 2201-001122
- Practice address
- 29 Fairfax St SE
Leesburg, VA 20175-3617 - Phone
- (703) 777-6424
- Fax
- (703) 777-6456
- NPI assigned
- Jun 7, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 2201-001122 | VA | Primary |
| Audiologist-Hearing Aid Fitter | 237600000X | 2101-001388 | VA |
Addresses
Primary practice location
29 Fairfax St SE
Leesburg, VA 20175-3617
Mailing address
29 Fairfax St SE
Leesburg, VA 20175-3617
Phone (703) 777-6424
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010142725 | Medicaid | VA | |
| 010142717 | Medicaid | VA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2201-001122 | VA | MD | Audiologist |
| 2101-001388 | VA | MD | Audiologist-Hearing Aid Fitter |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Hearing AIDS & Audiology, LLC | Audiologist | Past | Accepting new patients |
| Blue Ridge Speech & Hearing Center of Loudoun County, Inc. | Audiologist | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/7509/brand/1/csg/1/fhir/r4
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 and National Provider Directory roles.
-
- Audiologist
- Leesburg, VA
- NPI 1962681189
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- Audiologist
- Lansdowne, VA
- NPI 1558304253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389312000000",
"number": "1720028087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29 FAIRFAX ST SE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201753617",
"telephone_number": "703-777-6424",
"fax_number": "703-777-6456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 FAIRFAX ST SE",
"city": "LEESBURG",
"state": "VA",
"postal_code": "201753617",
"telephone_number": "703-777-6424",
"fax_number": "703-777-6456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKER",
"first_name": "SHARON",
"name_prefix": "Dr.",
"credential": "AU.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-06-07",
"last_updated": "2014-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "VA",
"license": "2201-001122",
"primary": true
},
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "VA",
"license": "2101-001388",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010142725",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "010142717",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Leesburg, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.