Individual provider Active NPI

Corry L. Wilcox, M.A.

  • Audiologist
  • Lancaster, OH
National Provider Identifier
1760500482
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
A-01182 Issued in OH
Practice address
1303 River Valley Blvd Ste B
Lancaster, OH 43130-1669
Phone
(740) 654-3571
Fax
(740) 689-3277
NPI assigned
Mar 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X A-01182 OH Primary

Addresses

Primary practice location

1303 River Valley Blvd Ste B
Lancaster, OH 43130-1669

Mailing address

1303 River Valley Blvd Ste B
Lancaster, OH 43130-1669
Phone (740) 654-3571

Other identifiers 2

IdentifierTypeStateIssuer
2104681MedicaidOH
000000230171OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151218001698 OH Practitioner - Qualified Audiologist 7618900739 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Ohio University, College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Audiology Associates of Lancaster, L.L.C.Group PAC ID 6709819824, 3 clinicians

Practice addresses (Care Compare)

1303 River Valley Blvd
Suite B
Lancaster, OH 43130-1669
Phone (740) 654-3571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A-01182OHMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Audiology Associates of Lancaster, L.L.C. Audiologist CurrentSince Mar 1, 1999 Accepting new patients

Locations

1303 River Valley Blvd
Ste B
Lancaster, OH 43130
Phone (740) 654-3571

4850 E Main St
Whitehall, OH 43213
Phone (614) 523-2266

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": "1174953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760500482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 RIVER VALLEY BLVD STE B",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301669",
            "telephone_number": "740-654-3571",
            "fax_number": "740-689-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 RIVER VALLEY BLVD STE B",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431301669",
            "telephone_number": "740-654-3571",
            "fax_number": "740-689-3277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "CORRY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OH",
            "license": "A-01182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104681",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000230171",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.