Active NPI
Ann McKiernan
- Speech-Language Pathologist
- Marshfield, WI
National Provider Identifier
1609041870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2203-154
- Practice address
- 209 Wilderness View Dr
Marshfield, WI 54449-8357 - Phone
- (715) 389-6000
- Fax
- (715) 389-6090
- NPI assigned
- Apr 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 2203-154 | WI | Primary |
Addresses
Primary practice location
209 Wilderness View Dr
Marshfield, WI 54449-8357
Mailing address
209 Wilderness View Dr
Marshfield, WI 54449-8357
Phone (715) 389-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42783400 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2203-154 | WI | MD | Speech-Language Pathologist |
| 2203 | WI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209340800000",
"number": "1609041870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 WILDERNESS VIEW DR",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544498357",
"telephone_number": "715-389-6000",
"fax_number": "715-389-6090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 WILDERNESS VIEW DR",
"city": "MARSHFIELD",
"state": "WI",
"postal_code": "544498357",
"telephone_number": "715-389-6000",
"fax_number": "715-389-6090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKIERNAN",
"first_name": "ANN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-04-28",
"last_updated": "2008-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "2203-154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42783400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marshfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.