Individual provider Active NPI

Amy Laurell Krueger, MS-CCC-SLP

  • Speech-Language Pathologist
  • Sheboygan, WI
National Provider Identifier
1023020849
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2414-154 Issued in WI
Practice address
2508 Cooper Ave
Sheboygan, WI 53083-4471
Phone
(920) 889-5095
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2414-154 WI Primary

Addresses

Primary practice location

2508 Cooper Ave
Sheboygan, WI 53083-4471

Mailing address

2508 Cooper Ave
Sheboygan, WI 53083-4471
Phone (920) 889-5095

Other identifiers 1

IdentifierTypeStateIssuer
42587200MedicaidWI

Other names 1

  • Ms. Amy Laurell Delain Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220722002152 WI Practitioner - Qualified Speech Language Pathologist 5294116133 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Therapy Services LLC Speech-Language Pathologist CurrentSince Jul 11, 2022 Accepting new patients

Locations

8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442

2961 Saint Anthony Dr
Green Bay, WI 54311
Phone (920) 468-0861

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1023020849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2508 COOPER AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834471",
            "telephone_number": "920-889-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 COOPER AVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530834471",
            "telephone_number": "920-889-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "AMY",
        "middle_name": "LAURELL",
        "name_prefix": "Mrs.",
        "credential": "MS-CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-12",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2414-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42587200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "DELAIN",
            "middle_name": "LAURELL",
            "prefix": "MS.",
            "credential": "MS-CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sheboygan, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; 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.