Tim Van Der Perren

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1928-154 Issued in WI

Practice address

501 Park Ave
Oconto, WI 54153-1612

Phone

(920) 834-6875

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Clare Memorial Hospital, Inc

  • Critical Access Hospital
  • Oconto Falls, WI
  • NPI 1851477913
  Medicare reassignment
• St. Clare Memorial Hospital, Inc

  dba HSHS SCO Regional Surgery Center Marinette

  • Surgery Physician
  • Marinette, WI
  • NPI 1962861294
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972615292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2543 TELLURIDE TRL APT C",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543133972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 PARK AVE",
            "city": "OCONTO",
            "state": "WI",
            "postal_code": "541531612",
            "telephone_number": "920-834-6875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER PERREN",
        "first_name": "TIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "1928-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St Vincent Hospital-Hospital Sisters-Third Order of St Francis (St. Vincent Hospital-Libertas of Oconto)
• Elizabeth R Stukenberg, DNP, APNP, FNP-BC
• The Lakes Community Health Center, Inc (NorthLakes Community Clinic)
• Coral A Thomson, DPT
• Amber M Trepanier, RDH
• Rebecca M. Vissers, APNP
• Shannon Weed
• Joshua Ammon Weenig, DMD
• Amanda K Westmoreland, PA
• Kyle Whiteside, DMD

• Speech-Language Pathologist in Oconto, WI
• Providers in Oconto, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.