Ephphatha Tiny Mouth Therapy LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EPHPHATHA TINY MOUTH THERAPY LLC

Practice address

490 W Rolling Meadows Dr
Fond Du Lac, WI 54937-8624

Phone

(262) 483-6597

NPI assigned

May 22, 2023

Last updated

May 22, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Bridget Schumaker, CCC-SLPNPI 1871843342

Title

Owner

Phone

(262) 483-6597

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bridget Schumaker

  • Speech-Language Pathologist
  • Beaver Dam, WI
  • NPI 1871843342
  NPD Authorized official

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

{
    "created_epoch": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1245922095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9565 BOLTONVILLE RD",
            "city": "KEWASKUM",
            "state": "WI",
            "postal_code": "530409730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 W ROLLING MEADOWS DR",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549378624",
            "telephone_number": "262-483-6597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPHPHATHA TINY MOUTH THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "SCHUMAKER",
        "authorized_official_first_name": "BRIDGET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-483-6597",
        "authorized_official_credential": "CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy S Emmer-Sheldon, MD
• Martha A Endejan
• Therese Endres
• Oana Enea, D.O.
• Mallory Engelhardt
• Connie Ernser
• Alan Ernst
• Jace Tanner Erwin, MD
• Essmann Counseling, LLC
• Essmann Counseling, LLC

• Clinic/Center in Fond Du Lac, WI
• Providers in Fond Du Lac, WI by specialty
• Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.