Individual provider Active NPI

Jacquelyn A Schmida, CCC SLP

  • Speech-Language Pathologist
  • La Crosse, WI
National Provider Identifier
1215912662
Registry record updated Jan 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
651 Issued in WI
Practice address
901 Caledonia St
La Crosse, WI 54603-2616
Phone
(608) 785-4100
Fax
(608) 785-4101
NPI assigned
Dec 8, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2017

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 651 WI Primary

Addresses

Primary practice location

901 Caledonia St
La Crosse, WI 54603-2616

Mailing address

901 Caledonia St
La Crosse, WI 54603-2616
Phone (608) 785-4100

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
6021MNMDChiropractor
651WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1215912662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CALEDONIA ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032616",
            "telephone_number": "608-785-4100",
            "fax_number": "608-785-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CALEDONIA ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032616",
            "telephone_number": "608-785-4100",
            "fax_number": "608-785-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDA",
        "first_name": "JACQUELYN",
        "middle_name": "A",
        "credential": "CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-08",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.