Individual provider Active NPI

Shawna Marie Berenz, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Milwaukee, WI
National Provider Identifier
1861829319
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3863-154 Issued in WI
Practice address
833 N 26TH St
Milwaukee, WI 53233-1507
Phone
(414) 344-7676
NPI assigned
Sep 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2015

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 3863-154 WI Primary

Addresses

Primary practice location

833 N 26TH St
Milwaukee, WI 53233-1507

Mailing address

833 N 26TH St
Milwaukee, WI 53233-1507
Phone (414) 344-7676

Other identifiers 1

IdentifierTypeStateIssuer
1861829319MedicaidWI

Other names 1

  • Shawna Marie Reilley Former name

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3863-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1380499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1861829319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 N 26TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331507",
            "telephone_number": "414-344-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 N 26TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532331507",
            "telephone_number": "414-344-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERENZ",
        "first_name": "SHAWNA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-30",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3863-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861829319",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHAWNA",
            "last_name": "REILLEY",
            "middle_name": "MARIE",
            "credential": "M.S., CFY-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.