Individual provider Active NPI

Dawn Marie La Luzerne, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Green Bay, WI
National Provider Identifier
1568639664
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1200-154 Issued in WI
Practice address
2231 Maccaux Dr
Green Bay, WI 54302-4531
Phone
(773) 633-7593
NPI assigned
May 8, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2008

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 1200-154 WI Primary

Addresses

Primary practice location

2231 Maccaux Dr
Green Bay, WI 54302-4531

Mailing address

2231 Maccaux Dr
Green Bay, WI 54302-4531
Phone (773) 633-7593

Other names 1

  • Dawn Marie Kale Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1200-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210204800000",
    "number": "1568639664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 MACCAUX DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024531",
            "telephone_number": "773-633-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 MACCAUX DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543024531",
            "telephone_number": "773-633-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LA LUZERNE",
        "first_name": "DAWN",
        "middle_name": "MARIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1200-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "KALE",
            "middle_name": "MARIE",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.