Individual provider Active NPI

Sharon Wicker, AU.D.

  • Audiologist
  • Leesburg, VA
National Provider Identifier
1720028087
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
2201-001122 Issued in VA
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

Updated by the provider on Jan 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
010142725MedicaidVA
010142717MedicaidVA

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

LicenseStateTypeSpecialty
2201-001122VAMDAudiologist
2101-001388VAMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hearing AIDS & Audiology, LLC Audiologist PastSince Oct 1, 2007 Accepting new patients
Blue Ridge Speech & Hearing Center of Loudoun County, Inc. Audiologist Past Accepting new patients

Interoperability endpoints

  • FHIR API: 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.

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.

Verify at the official NPI Registry.