Active NPI
Cheryl Marie Churchill I
- Speech-Language Pathologist
- Hayward, WI
National Provider Identifier
1295909059
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1812-154
- Practice address
- 15592 Lakewood Dr
Hayward, WI 54843-6406 - Phone
- (715) 934-3116
- NPI assigned
- Apr 14, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 1812-154 | WI | Primary |
Addresses
Primary practice location
15592 Lakewood Dr
Hayward, WI 54843-6406
Mailing address
15592 Lakewood Dr
Hayward, WI 54843-6406
Phone (715) 934-3116
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1812-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1208131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208131200000",
"number": "1295909059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15592 LAKEWOOD DR",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548436406",
"telephone_number": "715-934-3116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15592 LAKEWOOD DR",
"city": "HAYWARD",
"state": "WI",
"postal_code": "548436406",
"telephone_number": "715-934-3116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCHILL",
"first_name": "CHERYL",
"middle_name": "MARIE",
"name_suffix": "I",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-14",
"last_updated": "2008-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "1812-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.