Individual provider Active NPI

Courtney Miklos, SPEECH PATHOLOGY

  • Speech-Language Pathologist
  • Milwaukee, WI
National Provider Identifier
1932552247
Registry record updated Jul 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4320-154 Issued in WI
Practice address
1635 N Water St
Apartment #513
Milwaukee, WI 53202-2061
Phone
(630) 408-5006
NPI assigned
Jul 21, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2016

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 4320-154 WI Primary

Addresses

Primary practice location

1635 N Water St
Apartment #513
Milwaukee, WI 53202-2061

Mailing address

1635 N Water St
Apartment #513
Milwaukee, WI 53202-2061
Phone (630) 408-5006

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

State licenses

LicenseStateTypeSpecialty
4320-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469059200000",
    "number": "1932552247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N WATER ST",
            "address_2": "APARTMENT #513",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022061",
            "telephone_number": "630-408-5006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N WATER ST",
            "address_2": "APARTMENT #513",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532022061",
            "telephone_number": "630-408-5006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKLOS",
        "first_name": "COURTNEY",
        "credential": "SPEECH PATHOLOGY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2016-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "4320-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 21, 2016; 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.