Diana M Vodicka, MS CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

220 Issued in WI

Practice address

1190 E Paradise Dr
West Bend, WI 53095-5444

Phone

(262) 306-6319

NPI assigned

Jul 27, 2007

Last updated

Dec 5, 2012By 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 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354665600000",
    "number": "1306036116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 W PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530959795",
            "telephone_number": "262-334-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1190 E PARADISE DR",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530955444",
            "telephone_number": "262-306-6319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VODICKA",
        "first_name": "DIANA",
        "middle_name": "M",
        "credential": "MS CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2012-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42670600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nipun Gupta Verma, M.D.
• Kaylin Visauer, APNP
• Vision Mart, Inc (Vision Mart)
• Visionworks
• Visionworks, Inc. (Visionworks)
• Sarah Vogt
• Raeann Volbright
• Brett Vollmer, DPT
• Lisa Vorwerk, COTA
• Jill Wagner, RN, RCS

• Speech-Language Pathologist in West Bend, WI
• Providers in West Bend, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.