Olivia C. Van Wagner, MA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

41YA00025500 Issued in NJ

Practice address

860 Lower Ferry Rd Ste 2
Ewing, NJ 08628-3516

Phone

(609) 245-0006

NPI assigned

Oct 2, 2008

Last updated

Mar 14, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Olivia W, Conyers Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Olivia Van Wagner, LLC

  dba Ewing Hearing Health

  • Audiologist
  • Ewing, NJ
  • NPI 1801308259
  Authorized official Same address or phone

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520985600000",
    "number": "1861643314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 LOWER FERRY RD STE 2",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283516",
            "telephone_number": "609-245-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 LOWER FERRY RD STE 2",
            "city": "EWING",
            "state": "NJ",
            "postal_code": "086283516",
            "telephone_number": "609-245-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WAGNER",
        "first_name": "OLIVIA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-02",
        "last_updated": "2018-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "NJ",
            "license": "41YA00025500",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "NJ",
            "license": "25MG000646000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "OLIVIA",
            "last_name": "CONYERS",
            "middle_name": "W,",
            "prefix": "MS.",
            "credential": "MA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Two Enterprise Inc.
• Christopher Unger, MS, ATC, LAT
• Manan S Vaghela, RPH,MS
• Snehaben Vakharia
• Valentine's LLC
• Cassie Vanderveer, LCSW
• Tara Hungspruke Vanhise, D.O.
• Walter Joseph Varan, LCSW
• Tetyana Vasylenko, L.AC.
• Veder & Veder, PC

• Audiologist in Ewing, NJ
• Providers in Ewing, NJ by specialty
• Audiologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2018; 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.