Jacob Koepke

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6293154 Issued in WI

Practice address

3821 Kohler Memorial Dr
Sheboygan, WI 53081-3600

Phone

(920) 208-9648

NPI assigned

Jun 21, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1730864265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3821 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3821 KOHLER MEMORIAL DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813600",
            "telephone_number": "920-208-9648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEPKE",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "6293154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brett S Knudsen
• Lynn A Koblewski
• Casimer Kobylinski I, D. C.
• Timothy C Koch, DO
• Nancy Ellen Koene, LCSW
• Glen R Kohlhagen, OD
• Hailee Rae Kohlhagen, OD
• Taylor R Kohlhagen, DO
• Brittany Kohlmann, OTR
• Wendy Jean Kolb, RN

• Speech-Language Pathologist in Sheboygan, WI
• Providers in Sheboygan, 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 Jun 21, 2023; 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.