Individual provider Active NPI

Sophia Kim Marie Thiede, SLP-CF

  • Speech-Language Pathologist
  • Medford, WI
National Provider Identifier
1184301129
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6854154 Issued in WI
Practice address
103 S Gibson St
Medford, WI 54451-1622
Phone
(715) 748-8112
NPI assigned
Jun 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6854154 WI Primary
Speech-Language Pathologist 235Z00000X 6320154 WI

Addresses

Primary practice location

103 S Gibson St
Medford, WI 54451-1622

Mailing address

103 S. Gibson Street
Medford, WI 54451
Phone (715) 965-8112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230817003290 WI Practitioner - Qualified Speech Language Pathologist 7911369277 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6320154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jul 31, 2023 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc. CurrentSince Jul 31, 2023 Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Medford Hospital & Clinics, Inc. CurrentSince Jul 31, 2023 Accepting new patients
Aspirus Stanley Hospital & Clinics, Inc CurrentSince Jul 31, 2023 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

135 S Gibson St
Medford, WI 54451
Phone (715) 748-8100

103 S Gibson St
Medford, WI 54451
Phone (715) 748-8112

1120 Pine St
Stanley, WI 54768
Phone (715) 644-5530

Organizations & group practices 6

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": "1688083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1184301129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 S. GIBSON STREET",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "54451",
            "telephone_number": "715-965-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 S GIBSON ST",
            "city": "MEDFORD",
            "state": "WI",
            "postal_code": "544511622",
            "telephone_number": "715-748-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEDE",
        "first_name": "SOPHIA",
        "middle_name": "KIM MARIE",
        "credential": "SLP-CF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-30",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "6854154",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "6320154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; 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.