Becky Wallin, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3680-154 Issued in WI

Practice address

1305 Old 8 Rd
Ladysmith, WI 54848-9457

Phone

(715) 415-5241

NPI assigned

Jun 6, 2012

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Menomonee Falls, WI
  • NPI 1003174087

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Paxxon Healthcare Services LLC

  • Physical Therapist
  • Colorado Springs, CO
  • NPI 1336808146
  NPD
• Rehabcare Group East, LLC

  dba RehabCare

  • Rehabilitation Clinic/Center
  • Greenfield, WI
  • NPI 1326099128
  NPD (past)

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1619238581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 OLD 8 RD",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548489457",
            "telephone_number": "715-415-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 OLD 8 RD",
            "city": "LADYSMITH",
            "state": "WI",
            "postal_code": "548489457",
            "telephone_number": "715-415-5241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "BECKY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3680-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100029239",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Inimfon Udoh, M.D
• Heather Marie Vandoorn, COTA
• Corrine M Verdegan, M.S. CCC-SLP
• Kristin E Verville, MD
• Wal-Mart Stores East LP (Walmart Pharmacy 10-4281)
• Vern W Weeks, MSSW
• Western Region Recovery & Wellness Consortia
• Wildwood Acupuncture
• Willow Tree Mental Health Clinic, LLC
• Katherine Suzanne Winiarczyk, MD

• Speech-Language Pathologist in Ladysmith, WI
• Providers in Ladysmith, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.