Individual provider Active NPI

Ruthanne Marie Tice, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Fond Du Lac, WI
National Provider Identifier
1992971311
Registry record updated Nov 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3050-154 Issued in WI
Practice address
845 S Main St Ste 120
Fond Du Lac, WI 54935-6116
Phone
(920) 379-5621
NPI assigned
May 6, 2008
Last updated
Nov 9, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2017

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 3050-154 WI Primary

Addresses

Primary practice location

845 S Main St Ste 120
Fond Du Lac, WI 54935-6116

Mailing address

661 Mendota CT Apt 1001
Madison, WI 53703-1164
Phone (920) 379-5621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220718001112 WI Practitioner - Qualified Speech Language Pathologist 7911388368 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oasis Therapy Services LLCGroup PAC ID 8325427974, 73 clinicians

Practice addresses (Care Compare)

631 Hazel St
Oshkosh, WI 54901-4600
Phone (920) 393-9998

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Oasis Therapy Services LLC Speech-Language Pathologist CurrentSince Jun 15, 2022 Accepting new patients

Locations

8170 McCormick Blvd
Ste 112
Skokie, IL 60076
Phone (920) 252-4442

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1510185600000",
    "number": "1992971311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 MENDOTA CT APT 1001",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031164",
            "telephone_number": "920-379-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S MAIN ST STE 120",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549356116",
            "telephone_number": "920-379-5621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICE",
        "first_name": "RUTHANNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-06",
        "last_updated": "2017-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3050-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.