Active NPI
Amy M. Kohlstedt, M.S. CCC-SLP
- Speech-Language Pathologist
- Madison, WI
National Provider Identifier
1023139763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2227-154
- Practice address
- 202 S Park St
Madison, WI 53715-1507 - Phone
- (608) 417-7574
- NPI assigned
- Apr 2, 2007
- Last updated
- Sep 20, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2227-154 | WI | Primary |
Addresses
Primary practice location
202 S Park St
Madison, WI 53715-1507
Mailing address
519 Mark Dr
Verona, WI 53593-1022
Phone (608) 848-9416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42787600 | Medicaid | WI |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2227-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1023139763",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "519 MARK DR",
"city": "VERONA",
"state": "WI",
"postal_code": "535931022",
"telephone_number": "608-848-9416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "202 S PARK ST",
"city": "MADISON",
"state": "WI",
"postal_code": "537151507",
"telephone_number": "608-417-7574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOHLSTEDT",
"first_name": "AMY",
"middle_name": "M.",
"name_prefix": "Mrs.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "2227-154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42787600",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Madison, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.