Individual provider Active NPI

Sandra Korthas

  • Speech-Language Pathologist
  • Milwaukee, WI
National Provider Identifier
1386850782
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
Center for Blind & Visually Impaired Children
5600 W Brown Deer Rd, Ste. 4
Milwaukee, WI 53223
Phone
(414) 355-3060
Fax
(414) 355-3547
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 Primary

Addresses

Primary practice location

Center for Blind & Visually Impaired Children
5600 W Brown Deer Rd, Ste. 4
Milwaukee, WI 53223

Mailing address

2609 Faringdon CT
Waukesha, WI 53188-1343
Phone (262) 547-5973

Other identifiers 1

IdentifierTypeStateIssuer
42692900MedicaidWI

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386850782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 FARINGDON CT",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531881343",
            "telephone_number": "262-547-5973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CENTER FOR BLIND & VISUALLY IMPAIRED CHILDREN",
            "address_2": "5600 W BROWN DEER RD, STE. 4",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53223",
            "telephone_number": "414-355-3060",
            "fax_number": "414-355-3547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTHAS",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42692900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.