Individual provider Active NPI

Brynn Crawley

  • Speech-Language Pathologist
  • Peshtigo, WI
National Provider Identifier
1124478284
Registry record updated Jun 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4292 Issued in WI
Practice address
701 Willow St
Peshtigo, WI 54157-1165
Phone
(715) 582-0144
Fax
(715) 582-0803
NPI assigned
Jun 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2016

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 4292 WI Primary

Addresses

Primary practice location

701 Willow St
Peshtigo, WI 54157-1165

Mailing address

1098 Harbor Lights Rd
Suamico, WI 54173-8005
Phone (920) 660-1545

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
4292WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
RG-Rhinelander, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1124478284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1098 HARBOR LIGHTS RD",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "541738005",
            "telephone_number": "920-660-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 WILLOW ST",
            "city": "PESHTIGO",
            "state": "WI",
            "postal_code": "541571165",
            "telephone_number": "715-582-0144",
            "fax_number": "715-582-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAWLEY",
        "first_name": "BRYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peshtigo, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.