Active NPI
Beth M Thornton, SLP
- Speech-Language Pathologist
- Waterford, WI
National Provider Identifier
1235356130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2551-154
- Practice address
- 1701 Sharp Rd
Waterford, WI 53185-5214 - Phone
- (262) 534-7297
- Fax
- (262) 534-7257
- NPI assigned
- Apr 20, 2007
- 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 | 2551-154 | WI | Primary |
Addresses
Primary practice location
1701 Sharp Rd
Waterford, WI 53185-5214
Mailing address
W330S8190 Country LN S
Mukwonago, WI 53149-9258
Phone (262) 853-4498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2210 Dufek Dr
Manitowoc, WI 54220-9356
Phone (920) 652-0534
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paxxon Healthcare Services LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Paxxon Healthcare Services LLC | Current | Accepting new patients | |
| Powerback Rehabilitation LLC | Speech-Language Pathologist | Past | Accepting new patients |
Locations
2210 Dufek Dr
Manitowoc, WI 54220
Phone (715) 574-4724
1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207
Organizations & group practices 3
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.
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Speech-Language Pathologist
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Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235356130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W330S8190 COUNTRY LN S",
"city": "MUKWONAGO",
"state": "WI",
"postal_code": "531499258",
"telephone_number": "262-853-4498"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1701 SHARP RD",
"city": "WATERFORD",
"state": "WI",
"postal_code": "531855214",
"telephone_number": "262-534-7297",
"fax_number": "262-534-7257"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "BETH",
"middle_name": "M",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "2551-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Waterford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.