Active NPI
Mark P Runge, SLP
- Speech-Language Pathologist
- New Holstein, WI
National Provider Identifier
1730327602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2047-154
- Practice address
- 1610 Hoover St
New Holstein, WI 53061-1636 - Phone
- (920) 898-5706
- NPI assigned
- Jan 29, 2009
- Sex
- Male
- Sole proprietor
- No
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 | 2047-154 | WA | Primary |
Addresses
Primary practice location
1610 Hoover St
New Holstein, WI 53061-1636
Mailing address
1610 Hoover St
New Holstein, WI 53061-1636
Phone (920) 898-5706
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2047-154 | WA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233187200000",
"number": "1730327602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1610 HOOVER ST",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530611636",
"telephone_number": "920-898-5706"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1610 HOOVER ST",
"city": "NEW HOLSTEIN",
"state": "WI",
"postal_code": "530611636",
"telephone_number": "920-898-5706"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUNGE",
"first_name": "MARK",
"middle_name": "P",
"name_prefix": "Mr.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-01-29",
"last_updated": "2009-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WA",
"license": "2047-154",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Holstein, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.