Individual provider Active NPI

Avery Kaumeyer, CCC-SLP

  • Speech-Language Pathologist
  • Janesville, WI
National Provider Identifier
1356205058
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7218-154 Issued in WI
Practice address
101 E Milwaukee St Ste 507
Janesville, WI 53545-3004
Phone
(608) 728-7774
Fax
(608) 621-3804
NPI assigned
Dec 16, 2025
Last updated
Dec 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7218-154 WI Primary

Addresses

Primary practice location

101 E Milwaukee St Ste 507
Janesville, WI 53545-3004

Mailing address

101 E Milwaukee St Ste 507
Janesville, WI 53545-3004
Phone (608) 728-7774

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231000532 WI Practitioner - Qualified Speech Language Pathologist 3577059427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1001 W Glen Oaks LN
Suite 105
Mequon, WI 53092-3369

1243 Timber Creek Dr
Murfreesboro, TN 37128-3896

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7218-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Marigold Speech Pathology Services, LLC Speech-Language Pathologist CurrentSince Dec 22, 2025 Accepting new patients

Locations

1001 W Glen Oaks Ln
Ste 105
Mequon, WI 53092
Phone (414) 258-8314

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1765843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1356205058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MILWAUKEE ST STE 507",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453004",
            "telephone_number": "608-728-7774",
            "fax_number": "608-621-3804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E MILWAUKEE ST STE 507",
            "city": "JANESVILLE",
            "state": "WI",
            "postal_code": "535453004",
            "telephone_number": "608-728-7774",
            "fax_number": "608-621-3804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUMEYER",
        "first_name": "AVERY",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-16",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "7218-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Janesville, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.