Traci L Wilkerson Aud Inc PC

Primary specialty

AudiologistTaxonomy code 231H00000X

License

144 Issued in OK

Legal business name

TRACI L WILKERSON AUD INC PC

Practice address

3312 W Okmulgee St
Muskogee, OK 74401-5069

Phone

(918) 682-1515

Fax

(918) 682-1598

NPI assigned

Jun 8, 2007

Last updated

Jul 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Traci L Wilkerson, AUDNPI 1336342161

Title

Owner/Practitioner

Phone

(918) 682-1515

Specialties & licenses 3

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Traci Lee Wilkerson, AU.D.

  • Audiologist-Hearing Aid Fitter
  • Muskogee, OK
  • NPI 1336342161
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1181260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437177600000",
    "number": "1861695611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015069",
            "telephone_number": "918-682-1515",
            "fax_number": "918-682-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 W OKMULGEE ST",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744015069",
            "telephone_number": "918-682-1515",
            "fax_number": "918-682-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACI L WILKERSON AUD INC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-08",
        "last_updated": "2015-07-18",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "TRACI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRACTITIONER",
        "authorized_official_telephone_number": "918-682-1515",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "OK",
            "license": "144",
            "primary": true
        },
        {
            "code": "231HA2500X",
            "taxonomy_group": "",
            "desc": "Audiologist, Assistive Technology Supplier",
            "state": "OK",
            "license": "144",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "OK",
            "license": "144",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS - DDSD",
            "identifier": "100676030E",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DC 0957",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS - DDSD",
            "identifier": "100676030C",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS - DDSD",
            "identifier": "100676030D",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS - DDSD",
            "identifier": "100676030F",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "101410900",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Audiologist in Muskogee, OK
• Providers in Muskogee, OK by specialty
• Audiologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.