Active NPI
Kristen Siskovich
- Speech-Language Pathologist
- Fitchburg, WI
National Provider Identifier
1588015358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4318-154
- Practice address
- 2927 Fish Hatchery Rd.
Fitchburg, WI 53711 - Phone
- (608) 819-6394
- NPI assigned
- Jun 23, 2016
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 4318-154 | WI | Primary |
Addresses
Primary practice location
2927 Fish Hatchery Rd.
Fitchburg, WI 53711
Mailing address
4965 Stanbury Circle NW
Massillon, OH 44646
Phone (330) 754-5430
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 |
|---|---|---|---|
| 4318-154 | WI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Communication Innovations, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinic/Center
- Fitchburg, WI
- NPI 1508033564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466640000000",
"number": "1588015358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4965 STANBURY CIRCLE NW",
"city": "MASSILLON",
"state": "OH",
"postal_code": "44646",
"telephone_number": "330-754-5430"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2927 FISH HATCHERY RD.",
"city": "FITCHBURG",
"state": "WI",
"postal_code": "53711",
"telephone_number": "608-819-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISKOVICH",
"first_name": "KRISTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-23",
"last_updated": "2016-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "4318-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fitchburg, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.