Individual provider Active NPI

Jamie Ann Tesch, M.S. CCC- SLP

  • Speech-Language Pathologist
  • West Allis, WI
National Provider Identifier
1881994457
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3433-154 Issued in WI
Practice address
9047 W Greenfield Ave
West Allis, WI 53214-2808
Phone
(414) 607-0910
Fax
(414) 607-0924
NPI assigned
Oct 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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 3433-154 WI Primary

Addresses

Primary practice location

9047 W Greenfield Ave
West Allis, WI 53214-2808

Mailing address

9047 W Greenfield Ave
West Allis, WI 53214-2808
Phone (414) 607-0910

Other identifiers 1

IdentifierTypeStateIssuer
1881994457MedicaidWI

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
3433-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352160000000",
    "number": "1881994457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9047 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142808",
            "telephone_number": "414-607-0910",
            "fax_number": "414-607-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9047 W GREENFIELD AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532142808",
            "telephone_number": "414-607-0910",
            "fax_number": "414-607-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TESCH",
        "first_name": "JAMIE",
        "middle_name": "ANN",
        "credential": "M.S. CCC- SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-28",
        "last_updated": "2012-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3433-154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1881994457",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.