Active NPI
Jennifer Nicole Wallen, HIS
- Hearing Instrument Specialist
- Cape Coral, FL
National Provider Identifier
1760872139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- Practice address
- 1722 Del Prado Blvd S
Ste 2
Cape Coral, FL 33990-5525 - Phone
- (239) 458-7900
- Fax
- (239) 458-9977
- NPI assigned
- Jan 23, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | Primary |
Addresses
Primary practice location
1722 Del Prado Blvd S
Ste 2
Cape Coral, FL 33990-5525
Mailing address
215 Shuman Blvd
Ste. 401
Naperville, IL 60563-8458
Phone (630) 303-5380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AS5065 | Other | FL | HIS LICENSE |
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)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connect Hearing, Inc. | Hearing Instrument Specialist | Past | Accepting new patients |
| Connect Hearing Inc | Hearing Instrument Specialist | Past | Accepting new patients |
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.
-
- Hearing Aid Equipment
- Cape Coral, FL
- NPI 1477979771
Hearing Instrument Specialist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1421971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1421971200000",
"number": "1760872139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 SHUMAN BLVD",
"address_2": "STE. 401",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605638458",
"telephone_number": "630-303-5380",
"fax_number": "978-313-6824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1722 DEL PRADO BLVD S",
"address_2": "STE 2",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339905525",
"telephone_number": "239-458-7900",
"fax_number": "239-458-9977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLEN",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"credential": "HIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-01-23",
"last_updated": "2015-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIS LICENSE",
"identifier": "AS5065",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.