Active NPI
Olivia Ann Wagoner
- Audiologist
- Sterling Heights, MI
National Provider Identifier
1972435402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 1601001237
- Practice address
- 11080 Hall Rd Ste a
Sterling Heights, MI 48314-1511 - Phone
- (586) 254-7200
- NPI assigned
- Jun 1, 2026
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 1601001237 | MI | Primary |
Addresses
Primary practice location
11080 Hall Rd Ste a
Sterling Heights, MI 48314-1511
Mailing address
1851 Village Green Blvd Apt 207
Rochester Hills, MI 48307-6102
Phone (330) 888-8050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2026
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1 Ford PL
Detroit, MI 48202-3067
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1601001237 | MI | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780272000000",
"number": "1972435402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1851 VILLAGE GREEN BLVD APT 207",
"city": "ROCHESTER HILLS",
"state": "MI",
"postal_code": "483076102",
"telephone_number": "330-888-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11080 HALL RD STE A",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "483141511",
"telephone_number": "586-254-7200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAGONER",
"first_name": "OLIVIA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-01",
"last_updated": "2026-06-01",
"certification_date": "2026-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "MI",
"license": "1601001237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- 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.