Individual provider Active NPI

Jennifer Spann, SLP

  • Speech-Language Pathologist
  • Soldiers Grove, WI
National Provider Identifier
1962679324
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2773-154 Issued in WI
Practice address
101 Sunshine Blvd
Soldiers Grove, WI 54655-7106
Phone
(608) 624-5244
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2008

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 2773-154 WI Primary

Addresses

Primary practice location

101 Sunshine Blvd
Soldiers Grove, WI 54655-7106

Mailing address

S3921 Bakkom Rd
Viroqua, WI 54665-8163
Phone (608) 637-8759

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
2773-154WIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1962679324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S3921 BAKKOM RD",
            "city": "VIROQUA",
            "state": "WI",
            "postal_code": "546658163",
            "telephone_number": "608-637-8759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SUNSHINE BLVD",
            "city": "SOLDIERS GROVE",
            "state": "WI",
            "postal_code": "546557106",
            "telephone_number": "608-624-5244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "JENNIFER",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2773-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soldiers Grove, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.

Verify at the official NPI Registry.