Breanna Jane Minor

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4117-154 Issued in WI

Practice address

901 Caledonia St
La Crosse, WI 54603-2616

Phone

(608) 785-4100

NPI assigned

May 29, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Partners in Excellence Inc

  • Cognitive & Behavioral Psychologist
  • Burnsville, MN
  • NPI 1467598730
  Medicare reassignment

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485129600000",
    "number": "1790164283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 CALEDONIA ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032616",
            "telephone_number": "608-785-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 CALEDONIA ST",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546032616",
            "telephone_number": "608-785-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "BREANNA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2017-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4117-154",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "9463",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WISCONSIN DSPS",
            "identifier": "4117-154",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDH",
            "identifier": "9463",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassie Jean Mills
• Emma Ann Miloch
• Mind and Spine, LLC
• Callahan Apriline Minegar
• Kim Marie Minnaert, CRNA
• Michelle Collette Mirasola, SLP
• Joni L Mirehouse, PA
• Lori Ann Miskell, NP
• Mississippi Valley Physical Rehabilitation S.C.
• Kristin Mitchell, PT

• Speech-Language Pathologist in La Crosse, WI
• Providers in La Crosse, 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 Jan 23, 2017; 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.