Active NPI
Talia Lyn Nennig, SLP
- Speech-Language Pathologist
- Appleton, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5067-154
- 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
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 | 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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5067-154 | WI | MD | Speech-Language Pathologist |
| 5067 | WI | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Therapy Time for K.I.D.S. | Speech-Language Pathologist | Current | Accepting new patients |
| Bellin Memorial Hospital Inc | Current | Accepting new patients | |
| Bellin Memorial Hospital Inc | Current | 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.
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
-
- Speech-Language Pathologist
- Appleton, WI
- NPI 1114204567
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.