Individual provider Active NPI

Kathleen Levenhagen

  • Speech-Language Pathologist
  • Pewaukee, WI
National Provider Identifier
1174970792
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
804154 Issued in WI
Practice address
1284 Lake Park Dr
Pewaukee, WI 53072-2664
Phone
(262) 695-4496
NPI assigned
May 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 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 804154 WI Primary

Addresses

Primary practice location

1284 Lake Park Dr
Pewaukee, WI 53072-2664

Mailing address

1284 Lake Park Dr
Pewaukee, WI 53072-2664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812001318 WI Practitioner - Qualified Speech Language Pathologist 1850628074 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
804154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Services Wi LLC Speech-Language Pathologist CurrentSince Jul 1, 2024 Accepting new patients
Oasis Therapy Services LLC Speech-Language Pathologist CurrentSince Jun 21, 2024 Accepting new patients

Locations

8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442

Organizations & group practices 2

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1174970792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1284 LAKE PARK DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1284 LAKE PARK DR",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530722664",
            "telephone_number": "262-695-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEVENHAGEN",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-24",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "804154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pewaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.