Elaine Romenesko, SLP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1205239001 Issued in WI

Practice address

1703 60TH St
Kenosha, WI 53140-3986

Phone

(262) 309-0864

NPI assigned

Jan 14, 2020

Last updated

Jan 14, 2020By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1063052488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W286N3284 WOODGATE CT",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723327",
            "telephone_number": "262-309-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 60TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531403986",
            "telephone_number": "262-309-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMENESKO",
        "first_name": "ELAINE",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WI",
            "license": "1205239001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE SLP TEMPORARY LICENSE",
            "identifier": "4971-154",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Skilled Nursing Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.