Katrina Renee Gelhausen, M.S. CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

696980 Issued in WI

Practice address

112 Heatherview Dr
East Peoria, IL 61611-4889

Phone

(309) 360-0707

NPI assigned

Jul 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1376566067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10132 MENCHALVILLE RD",
            "city": "REEDSVILLE",
            "state": "WI",
            "postal_code": "542308008",
            "telephone_number": "920-901-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HEATHERVIEW DR",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616114889",
            "telephone_number": "309-360-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELHAUSEN",
        "first_name": "KATRINA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1757-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "696980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL EDUCATOR LICENSE",
            "identifier": "696980",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1757-154",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Miranda Gilliam
• Glas Chiropractic S.C.

• Speech-Language Pathologist in East Peoria, IL
• Providers in East Peoria, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.