Jean Anna Edwards, M.S.T. CCC-SLP

Primary specialty

Speech/Language/Hearing Specialist/TechnologistTaxonomy code 235500000X

License

1998-154 Issued in WI

Practice address

701 E 11TH St
New Richmond, WI 54017-2399

Phone

(715) 243-1615

NPI assigned

Sep 4, 2013

Last updated

Dec 12, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Jean Anna Pongratz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1245665744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E 11TH ST",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540172399",
            "telephone_number": "715-243-1615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E 11TH ST",
            "city": "NEW RICHMOND",
            "state": "WI",
            "postal_code": "540172399",
            "telephone_number": "715-243-1615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "JEAN",
        "middle_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "M.S.T. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-04",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "WI",
            "license": "1998-154",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1998-154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "PONGRATZ",
            "middle_name": "ANNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer Dombovy, LICSW
• Lisa Anne Dorenbush, OTR/L
• Alexandra Josephine Dorn, MS, LPC
• Benjamin Ward Dummer, MD
• Melissa Jean Dyshaw, D.P.T.
• Katherine Ellis, PT
• Kelley K Emerson-Quarne, MSW
• Sally Jo Emerson, RN
• Enhanced Eye Care LLC
• Ericksons Diversified LLC (Family Fresh Market Pharmacy)

• Speech/Language/Hearing Specialist/Technologist in New Richmond, WI
• Providers in New Richmond, WI by specialty
• Speech/Language/Hearing Specialist/Technologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.