NPIMap

Organization Active NPI

Mequon Speech and Learning Connection

  • Speech-Language Pathologist
  • Mequon, WI
National Provider Identifier
1720589476
Registry record updated Aug 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
MEQUON SPEECH AND LEARNING CONNECTION
Doing business as
Milwaukee Myo
Practice address
1025 W Glen Oaks LN Ste 107
Mequon, WI 53092-3372
Phone
(262) 302-4166
NPI assigned
Feb 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2019

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

Authorized official

Name
Jennifer Herklotz, MA CCC-SLP, COMNPI 1477796910
Title
Owner
Phone
(262) 302-4166

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

1025 W Glen Oaks LN Ste 107
Mequon, WI 53092-3372

Mailing address

1025 W Glen Oaks LN Ste 107
Mequon, WI 53092-3372
Phone (262) 302-4166

Other practice location 1

11431 N Port Washington Rd # 120
Mequon, WI 53092-3462
Phone (262) 302-4166

Other identifiers 2

IdentifierTypeStateIssuer
1497112122OtherNPI
1487843074OtherNPI

Other names 1

  • Milwaukee Myo Doing business as

National Provider Directory

National Provider Directory

Locations

11431 N Port Washington Rd
#120
Mequon, WI 53092
Phone (262) 302-4166

1025 W Glen Oaks Ln
Ste 107
Mequon, WI 53092
Phone (262) 302-4166

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1720589476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 W GLEN OAKS LN STE 107",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923372",
            "telephone_number": "262-302-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 W GLEN OAKS LN STE 107",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923372",
            "telephone_number": "262-302-4166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11431 N Port Washington Rd # 120",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530923462",
            "country_code": "US",
            "telephone_number": "262-302-4166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEQUON SPEECH AND LEARNING CONNECTION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-27",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "HERKLOTZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "262-302-4166",
        "authorized_official_credential": "MA CCC-SLP, COM"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497112122",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1487843074",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Milwaukee Myo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2019; 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.