Individual provider Active NPI

Monica Garvey Krueger

  • Speech-Language Pathologist
  • Fond Du Lac, WI
National Provider Identifier
1164075883
Registry record updated Jul 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4870-154 Issued in WI
Practice address
115 E Arndt St
Fond Du Lac, WI 54935-2461
Phone
(920) 923-7040
NPI assigned
Jul 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2019

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 4870-154 WI Primary

Addresses

Primary practice location

115 E Arndt St
Fond Du Lac, WI 54935-2461

Mailing address

13425 Brook Ave
Elm Grove, WI 53122-1711
Phone (414) 870-0040

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
4870-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1164075883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13425 BROOK AVE",
            "city": "ELM GROVE",
            "state": "WI",
            "postal_code": "531221711",
            "telephone_number": "414-870-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E ARNDT ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549352461",
            "telephone_number": "920-923-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUEGER",
        "first_name": "MONICA",
        "middle_name": "GARVEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4870-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.