Individual provider Active NPI

Kristin Lee Cavill, SLP

  • Speech-Language Pathologist
  • Fond Du Lac, WI
National Provider Identifier
1508058306
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2610-154 Issued in WI
Practice address
598 E 2ND St
Fond Du Lac, WI 54935-4519
Phone
(920) 843-1324
NPI assigned
Aug 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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 2610-154 WI Primary

Addresses

Primary practice location

598 E 2ND St
Fond Du Lac, WI 54935-4519

Mailing address

598 E 2ND St
Fond Du Lac, WI 54935-4519
Phone (920) 843-1324

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

State licenses

LicenseStateTypeSpecialty
2610-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1508058306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 E 2ND ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354519",
            "telephone_number": "920-843-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 E 2ND ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354519",
            "telephone_number": "920-843-1324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVILL",
        "first_name": "KRISTIN",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-15",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2610-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2014; 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.