Active NPI
Jessica Koehler
- Speech-Language Pathologist
- Verona, WI
National Provider Identifier
1184294506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5281-154
- Practice address
- 411 Prairie Heights Dr Ste 101
Verona, WI 53593-2238 - Phone
- (608) 556-6120
- NPI assigned
- Jun 28, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 5281-154 | WI | Primary |
Addresses
Primary practice location
411 Prairie Heights Dr Ste 101
Verona, WI 53593-2238
Mailing address
1324 Fish Hatchery Rd
Madison, WI 53715-1912
Phone (404) 754-9564
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5281-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624838400000",
"number": "1184294506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1324 FISH HATCHERY RD",
"city": "MADISON",
"state": "WI",
"postal_code": "537151912",
"telephone_number": "404-754-9564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 PRAIRIE HEIGHTS DR STE 101",
"city": "VERONA",
"state": "WI",
"postal_code": "535932238",
"telephone_number": "608-556-6120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOEHLER",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-28",
"last_updated": "2021-06-28",
"certification_date": "2021-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "5281-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Verona, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.