Individual provider Active NPI

Talia Lyn Nennig, SLP

  • Speech-Language Pathologist
  • Appleton, WI
National Provider Identifier
1861013989
Registry record updated Apr 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5067-154 Issued in WI
Practice address
W6127 Lorna LN
Appleton, WI 54915-7465
Phone
(920) 840-3033
Fax
(920) 882-4009
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5067-154 WI Primary

Addresses

Primary practice location

W6127 Lorna LN
Appleton, WI 54915-7465

Mailing address

PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210

Other practice location 1

555 Redbird Cir
DE Pere, WI 54115-7977
Phone (920) 338-6870

Other practice location 2

725 S Webster Ave
Green Bay, WI 54301-3500
Phone (920) 430-7100

Other names 1

  • Talia Lyn Jaskulske Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230418000490 WI Practitioner - Qualified Speech Language Pathologist 8022483411 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5067-154WIMDSpeech-Language Pathologist
5067WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bellin Memorial Hospital Inc Current Accepting new patients
Therapy Time for K.I.D.S. Speech-Language Pathologist CurrentSince Dec 7, 2025 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 5, 2023 Accepting new patients
Bellin Memorial Hospital Inc CurrentSince Apr 5, 2023 Accepting new patients

Locations

W6127 Lorna Ln
Appleton, WI 54915
Phone (920) 840-3033

555 Redbird Cir
Ste 300
De Pere, WI 54115
Phone (920) 338-6830

555 Redbird Cir
De Pere, WI 54115
Phone (920) 338-6820

744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025

725 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-7995

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1861013989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22487",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543052487",
            "telephone_number": "920-445-7210",
            "fax_number": "920-445-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W6127 LORNA LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549157465",
            "telephone_number": "920-840-3033",
            "fax_number": "920-882-4009"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "555 Redbird Cir",
            "address_purpose": "LOCATION",
            "city": "DE Pere",
            "state": "WI",
            "postal_code": "541157977",
            "country_code": "US",
            "telephone_number": "920-338-6870",
            "fax_number": "920-338-6829",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 S Webster Ave",
            "address_purpose": "LOCATION",
            "city": "Green Bay",
            "state": "WI",
            "postal_code": "543013500",
            "country_code": "US",
            "telephone_number": "920-430-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NENNIG",
        "first_name": "TALIA",
        "middle_name": "LYN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "5067-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TALIA",
            "last_name": "JASKULSKE",
            "middle_name": "LYN",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2023; 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.