Active NPI
Deborah Ann Noble-Olson, MACCCSLP
- Speech-Language Pathologist
- Superior, WI
National Provider Identifier
1982853164
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 42671800
- Practice address
- 2600 Catlin Ave
Superior, WI 54880-5133 - Phone
- (715) 394-8720
- Fax
- (715) 394-8760
- NPI assigned
- Sep 12, 2008
- Sex
- Female
- 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 | 42671800 | WI | Primary |
Addresses
Primary practice location
2600 Catlin Ave
Superior, WI 54880-5133
Mailing address
2600 Catlin Ave
Superior, WI 54880-5133
Phone (715) 394-8720
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42671800 | Medicaid | WI |
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 |
|---|---|---|---|
| 42671800 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221177600000",
"number": "1982853164",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2600 CATLIN AVE",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548805133",
"telephone_number": "715-394-8720",
"fax_number": "715-394-8760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2600 CATLIN AVE",
"city": "SUPERIOR",
"state": "WI",
"postal_code": "548805133",
"telephone_number": "715-394-8720",
"fax_number": "715-394-8760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOBLE-OLSON",
"first_name": "DEBORAH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "MACCCSLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-12",
"last_updated": "2008-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "42671800",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42671800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Superior, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.