Individual provider Active NPI

Hailey Elizabeth Boyer, SLP

  • Speech-Language Pathologist
  • Manitowoc, WI
National Provider Identifier
1114534823
Registry record updated Sep 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5087-154 Issued in WI
Practice address
2300 Western Ave
Manitowoc, WI 54220-3712
Phone
(920) 684-2011
NPI assigned
Sep 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2020

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 5087-154 WI Primary

Addresses

Primary practice location

2300 Western Ave
Manitowoc, WI 54220-3712

Mailing address

4152 Gemstone TRL
Green Bay, WI 54311-9001
Phone (902) 412-2845

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Unknown

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
5087-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1601078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601078400000",
    "number": "1114534823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4152 GEMSTONE TRL",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543119001",
            "telephone_number": "902-412-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 WESTERN AVE",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542203712",
            "telephone_number": "920-684-2011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "HAILEY",
        "middle_name": "ELIZABETH",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-26",
        "last_updated": "2020-09-26",
        "certification_date": "2020-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "5087-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "address_1": "2300 Western Ave",
            "city": "Manitowoc",
            "state": "WI",
            "country_code": "US",
            "postal_code": "542203712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.