Nancilyn K Ketola, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2184-154 Issued in WI

Practice address

2315 E Mooreland Road
New Berlin, WI 53151

Phone

(262) 798-7200

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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 and National Provider Directory roles.

• Presbyterian Homes of Wisconsin, Inc.

  • Rehabilitation Clinic/Center
  • Waukesha, WI
  • NPI 1336845551

  Speech-Language Pathologist

  Medicare reassignment NPD
• Presbyterian Homes of Wisconsin, Inc.

  • Rehabilitation Clinic/Center
  • Germantown, WI
  • NPI 1194414441

  Speech-Language Pathologist

  NPD
• Presbyterian Homes of Wisconsin, Inc.

  • Rehabilitation Clinic/Center
  • Muskego, WI
  • NPI 1720775489

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1710103494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W194S8371 SUMMERIDGE CT",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531508165",
            "telephone_number": "414-687-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 E MOORELAND ROAD",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "53151",
            "telephone_number": "262-798-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETOLA",
        "first_name": "NANCILYN",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2184-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710103494",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Loveneet Kaur
• Brian Patrick Kelley, DO
• Joseph P Kelly, DO
• Jeremy Kemmerling, O.D.
• Robert A Kessler, DO
• Meghan Kiernan, LPC
• Soo Ah Kim, M.D
• Kindred Pharmacy Services
• James King, M.D.
• Courtney Malina Kinney, PT

• Speech-Language Pathologist in New Berlin, WI
• Providers in New Berlin, 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 Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.