Kinsley Sara Hackman, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10586 Issued in MN

Practice address

1200 Grant Blvd W
Wabasha, MN 55981-1042

Phone

(651) 565-5558

NPI assigned

Mar 10, 2021

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

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Divine Savior Healthcare, Inc.

  • General Acute Care Hospital
  • Portage, WI
  • NPI 1124083894

  WI

  Medicare reassignment NPD
• Divine Savior Healthcare, Inc.

  • Rural Health Clinic/Center
  • Portage, WI
  • NPI 1386154417
  NPD

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1457936627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HACKMAN",
        "first_name": "KINSLEY",
        "middle_name": "SARA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eagle Valley Chiropractic LLC
• Colleen Etzbach, RHD, LPC
• Zachary Christopher Evans
• Mary Lou Fellows
• Carol Ann Groth
• Marc J. Hampl, PA-C
• Luke Carl Helland
• Kurt L Henn, PHARMD
• Tracy A Henn, PHARMD
• Colin Heraty

• All providers in Wabasha, MN
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.