Individual provider Active NPI

Colleen Ann Busche, MS/CCC-SLP

  • Speech-Language Pathologist
  • De Pere, WI
National Provider Identifier
1902136864
Registry record updated Dec 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1609-154 Issued in WI
Practice address
704 Desplaine Rd
De Pere, WI 54115-3718
Phone
(920) 217-4384
NPI assigned
Dec 28, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2009

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 1609-154 WI Primary

Addresses

Primary practice location

704 Desplaine Rd
De Pere, WI 54115-3718

Mailing address

704 Desplaine Rd
De Pere, WI 54115-3718
Phone (920) 217-4384

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
1609-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261958400000",
    "number": "1902136864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 DESPLAINE RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153718",
            "telephone_number": "920-217-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 DESPLAINE RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541153718",
            "telephone_number": "920-217-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCHE",
        "first_name": "COLLEEN",
        "middle_name": "ANN",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-28",
        "last_updated": "2009-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1609-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2009; 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.