Active NPI
Ronald Lee Dudash, MSCCCSLP
- Speech-Language Pathologist
- Rice Lake, WI
National Provider Identifier
1962678508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1402-154
- Practice address
- 19 W Newton St
Rice Lake, WI 54868-1744 - Phone
- (715) 234-2161
- NPI assigned
- May 4, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 1402-154 | WI | Primary |
Addresses
Primary practice location
19 W Newton St
Rice Lake, WI 54868-1744
Mailing address
19 W Newton St
Rice Lake, WI 54868-1744
Phone (715) 234-2161
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42788600 | Medicaid | WI | |
| 1402-154 | Other | WI | SPEECH LANGAGE PATHOLOGY LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1402-154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209859200000",
"number": "1962678508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 W NEWTON ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681744",
"telephone_number": "715-234-2161"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 W NEWTON ST",
"city": "RICE LAKE",
"state": "WI",
"postal_code": "548681744",
"telephone_number": "715-234-2161"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUDASH",
"first_name": "RONALD",
"middle_name": "LEE",
"credential": "MSCCCSLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-04",
"last_updated": "2008-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "1402-154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42788600",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH LANGAGE PATHOLOGY LICENSE",
"identifier": "1402-154",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rice Lake, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.