Active NPI
Wendy Clark, SLP
- Speech-Language Pathologist
- New Holstein, WI
National Provider Identifier
1306282298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1189-154
- Practice address
- W1905 Highway H
New Holstein, WI 53061-9545 - Phone
- (920) 207-6624
- NPI assigned
- May 17, 2013
- 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 | 1189-154 | WI | Primary |
Addresses
Primary practice location
W1905 Highway H
New Holstein, WI 53061-9545
Mailing address
W1905 Highway H
New Holstein, WI 53061-9545
Phone (920) 207-6624
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1189-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387152000000",
"number": "1306282298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W1905 HIGHWAY H",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530619545",
"telephone_number": "920-207-6624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W1905 HIGHWAY H",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530619545",
"telephone_number": "920-207-6624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "WENDY",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-17",
"last_updated": "2013-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "1189-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Holstein, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.