Kathryn Lynnae Ballweg, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3522-154 Issued in WI

Practice address

677 E State Street
Mount Carmel
Burlington, WI 53105-1639

Phone

(262) 763-9531

NPI assigned

Jul 18, 2011

Last updated

Mar 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kathryn Lynnae Smith Other name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sundance Rehabilitation LLCGroup PAC ID 7911815329, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

• Sundance Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Deforest, WI
  • NPI 1073912119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393804800000",
    "number": "1477841971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 E STATE STREET",
            "address_2": "MOUNT CARMEL",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051639",
            "telephone_number": "262-763-9531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 E STATE STREET",
            "address_2": "MOUNT CARMEL",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531051639",
            "telephone_number": "262-763-9531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLWEG",
        "first_name": "KATHRYN",
        "middle_name": "LYNNAE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-18",
        "last_updated": "2014-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3522-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SMITH",
            "middle_name": "LYNNAE",
            "prefix": "MS.",
            "credential": "M.S. CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Aurora Pharmacy Inc (Aurora Pharmacy)
• Laura Axelson
• Rebecca Lynn Baade, SLP
• Jeffrey W Bailet, MD
• Casey Balkowski
• Lori Jo Bansemer, MS.OTR,CHT
• Brianna Barker, APNP
• Susan M Barr, PA
• Lili Barsky, MD
• Brielle Bartes

• Speech-Language Pathologist in Burlington, WI
• Providers in Burlington, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.