Active NPI
Amanda Nicole Ihle, SLP
- Speech-Language Pathologist
- Hudson, WI
National Provider Identifier
1740503572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202005776
- Practice address
- 472 Park LN
Hudson, WI 54016-7524 - Phone
- (414) 339-4202
- NPI assigned
- Mar 8, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 2202005776 | VA | Primary |
Addresses
Primary practice location
472 Park LN
Hudson, WI 54016-7524
Mailing address
472 Park LN
Hudson, WI 54016-7524
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 |
|---|---|---|---|
| 2202005776 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268006400000",
"number": "1740503572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "472 PARK LN",
"city": "HUDSON",
"state": "WI",
"postal_code": "540167524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 PARK LN",
"city": "HUDSON",
"state": "WI",
"postal_code": "540167524",
"telephone_number": "414-339-4202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IHLE",
"first_name": "AMANDA",
"middle_name": "NICOLE",
"name_prefix": "Miss",
"credential": "SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-08",
"last_updated": "2010-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202005776",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hudson, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.