Individual provider Active NPI

Katherine Von Bergen-Donnelly, MS; CCC-SLP

  • Speech-Language Pathologist
  • Madison, WI
National Provider Identifier
1083569404
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1590057388 Issued in WI
Practice address
606 Gately Ter
Madison, WI 53711-1506
Phone
(608) 204-3288
NPI assigned
Mar 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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 1590057388 WI Primary

Addresses

Primary practice location

606 Gately Ter
Madison, WI 53711-1506

Mailing address

606 Gately Ter
Madison, WI 53711-1506
Phone (608) 204-3288

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

State licenses

LicenseStateTypeSpecialty
1590057388WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1772409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1083569404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 GATELY TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111506",
            "telephone_number": "608-204-3288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 GATELY TER",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537111506",
            "telephone_number": "608-204-3288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VON BERGEN-DONNELLY",
        "first_name": "KATHERINE",
        "credential": "MS; CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-02",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1590057388",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Mar 2, 2026; 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.