Mikaila Fager, MS, SLP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5262-154 Issued in WI

Practice address

Cerebral Palsy, Inc
2801 S Webster Ave
Green Bay, WI 54301

Phone

(920) 337-1122

Fax

(920) 337-1121

NPI assigned

May 21, 2021

Last updated

Nov 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mikaila Griffin Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1621555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1083289110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CEREBRAL PALSY, INC",
            "address_2": "2801 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-337-1121",
            "fax_number": "920-337-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CEREBRAL PALSY, INC",
            "address_2": "2801 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "telephone_number": "920-337-1122",
            "fax_number": "920-337-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGER",
        "first_name": "MIKAILA",
        "credential": "MS, SLP-CCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-21",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "5262-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "9203371126",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax number",
            "address_1": "2801 S Webster Ave",
            "city": "Green Bay",
            "state": "WI",
            "country_code": "US",
            "postal_code": "543012894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MIKAILA",
            "last_name": "GRIFFIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Eye Care Professionals Inc
• Eye See, LLC
• Meghan Callaghan Eytcheson, CCC-SLP
• Chinenye Vivian Ezembamalu, NP
• Allen E Faber, CRNA
• Pamela Jean Fager
• Timothy A Fagre, MD
• Daryl A Fahrner, PHARMD, MBA
• Pamela Falcon
• Steven H Falconer, MD

• Speech-Language Pathologist in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.

Verify at the official NPI Registry.