Active NPI
Anna E Novotny
- Speech-Language Pathologist
- Elkhorn, WI
National Provider Identifier
1508348962
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4959
- Practice address
- W3985 County Road NN
Elkhorn, WI 53121-4337 - Phone
- (262) 741-2000
- NPI assigned
- Sep 2, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4959 | WI | Primary |
| Speech-Language Pathologist | 235Z00000X | 242.004968 | IL |
Addresses
Primary practice location
W3985 County Road NN
Elkhorn, WI 53121-4337
Mailing address
W3985 County Road NN
Elkhorn, WI 53121-4337
Phone (262) 741-2000
Other practice location 1
4452 Squaw Prairie Rd
Belvidere, IL 61008
Phone (815) 547-6377
Other practice location 2
1660 S Mulford Rd
Rockford, IL 61108
Phone (815) 397-8700
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
| License | State | Type | Specialty |
|---|---|---|---|
| 242.004968 | IL | MD | Speech-Language Pathologist |
| 4959 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1508348962",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W3985 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214337",
"telephone_number": "262-741-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W3985 COUNTY ROAD NN",
"city": "ELKHORN",
"state": "WI",
"postal_code": "531214337",
"telephone_number": "262-741-2000"
}
],
"practiceLocations": [
{
"address_1": "4452 Squaw Prairie Rd",
"address_purpose": "LOCATION",
"city": "Belvidere",
"state": "IL",
"postal_code": "61008",
"country_code": "US",
"telephone_number": "815-547-6377",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1660 S Mulford Rd",
"address_purpose": "LOCATION",
"city": "Rockford",
"state": "IL",
"postal_code": "61108",
"country_code": "US",
"telephone_number": "815-397-8700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NOVOTNY",
"first_name": "ANNA",
"middle_name": "E",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-02",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "4959",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "242.004968",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elkhorn, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.