Active NPI
Luci Kennedy
- Speech-Language Pathologist
- Milwaukee, WI
National Provider Identifier
1295352938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5040154
- Practice address
- 3216 W Highland Blvd
Milwaukee, WI 53208-3252 - Phone
- (414) 344-6515
- NPI assigned
- Jun 29, 2020
- 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 | 5040154 | WI | Primary |
Addresses
Primary practice location
3216 W Highland Blvd
Milwaukee, WI 53208-3252
Mailing address
1415 Lone Oak Rd
Eagan, MN 55121-1113
Phone (612) 244-1712
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5040154 | WI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oasis Therapy Services LLC | Speech-Language Pathologist | Current | 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.
-
- Multi-Specialty Clinic/Center
- Oshkosh, WI
- NPI 1386381598
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1295352938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1415 LONE OAK RD",
"city": "EAGAN",
"state": "MN",
"postal_code": "551211113",
"telephone_number": "612-244-1712"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3216 W HIGHLAND BLVD",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532083252",
"telephone_number": "414-344-6515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "LUCI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-29",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "5040154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.