Individual provider Active NPI

Hannah Nicole Wesolowski, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Green Bay, WI
National Provider Identifier
1245087642
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6455154 Issued in WI
Practice address
981 Southern Cross Rd
Green Bay, WI 54303-6500
Phone
(920) 883-0459
NPI assigned
May 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2024

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 6455154 WI Primary

Addresses

Primary practice location

981 Southern Cross Rd
Green Bay, WI 54303-6500

Mailing address

981 Southern Cross Rd
Green Bay, WI 54303-6500
Phone (920) 241-6707

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
6455154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Green Bay Pediatric Therapy, LLC Speech-Language Pathologist CurrentSince May 7, 2024 Accepting new patients

Organizations & group practices 1

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": "1714608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1245087642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 SOUTHERN CROSS RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036500",
            "telephone_number": "920-241-6707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 SOUTHERN CROSS RD",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543036500",
            "telephone_number": "920-883-0459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESOLOWSKI",
        "first_name": "HANNAH",
        "middle_name": "NICOLE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-02",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "6455154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.