Individual provider Active NPI

Connie Nadler, CCC-A/SLP

  • Speech-Language Pathologist
  • Menomonie, WI
National Provider Identifier
1609323724
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
20236 Issued in CA
Practice address
N6916 538TH St
Menomonie, WI 54751-5591
Phone
(310) 990-7783
NPI assigned
Sep 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3176-154 WI
Speech-Language Pathologist 235Z00000X 20236 CA Primary

Addresses

Primary practice location

N6916 538TH St
Menomonie, WI 54751-5591

Mailing address

N6916 538TH St
Menomonie, WI 54751-5591
Phone (310) 990-7783

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
20236CAMDPharmacist
3176-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1609323724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N6916 538TH ST",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547515591",
            "telephone_number": "310-990-7783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N6916 538TH ST",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547515591",
            "telephone_number": "310-990-7783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADLER",
        "first_name": "CONNIE",
        "credential": "CCC-A/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3176-154",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "20236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

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

Verify at the official NPI Registry.