MS. TRACEY JANE WISE (NPI# 1912170564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912170564 |
| Entity Type | Individual |
| Full Name | MS. TRACEY JANE WISE |
| Other Name | MS. TRACEY JANE VAUGHN |
| Credential | MS CCC |
| Practice Address |
702 E King Rd Tomahawk WI 54487 |
| Mailing Address |
6608 Fallen Wood Ln Rhinelander WI 54501-8191 |
| Practice Telephone | 7152827566 |
| Mailing Telephone | 7152827566 |
| Enumeration Date | 2008-04-03 |
| Last Update Date | 2008-04-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 503-154 | WI | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 426259000 | 05 |
| Street Address |
702 E KING RD |
| City | TOMAHAWK |
| State | WI |
| Zip Code | 54487 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912100280 | Michael Patrick Reilly | Dentist | 1018 King Rd, Tomahawk, WI 54487 | 2007-06-06 |
| 1548463813 | Dewey Nickels Reilly | Dentist | 1018 Kings Rd, Tomahawk, WI 54487 | 2007-06-06 |
| 1972723716 | Northern Sight Vision Clinic, LLC | Optometrist | 318 N. 6th Street, Tomahawk, WI 54487 | 2007-04-26 |
| 1003974411 | Larry A Hagen | Optometrist | 318 North 6th St, Tomahawk, WI 54487 | 2006-12-05 |
| 1922174648 | Robert David Imm | Dentist | 318 N Sixth St, Tomahawk, WI 54487 | 2006-11-27 |
| 1962480707 | Stoxen Pharmacy | Pharmacy | 12 W Wisconsin Avenue, Tomahawk, WI 54487 | 2006-01-03 |
| 1841670015 | Jill Vanstrydonk | Physical Therapy Assistant | 202 W Mohawk Dr, Ministry Head 2 Toe Therapy, Tomahawk, WI 54487 | 2015-06-03 |
| 1063615342 | Reilly Family Dental LLC | Dentist | 1018 King Rd, Tomahawk, WI 54487 | 2007-06-06 |
| 1780887067 | Dewey Irving Reilly | Dentist | 1018 King Rd, Tomahawk, WI 54487 | 2007-06-06 |
| 1750556049 | Tomahawk Eye Care | Technician/Technologist | 28 S Tomahawk Ave, Tomahawk, WI 54487-1223 | 2008-04-28 |
| Find all providers in zip 54487 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700053147 | Sharon Arlene Silver | Speech-Language Pathologist | 304 Kaphaem Rd, Tomahawk, WI 54487-7800 | 2008-05-14 |
| 1699947473 | Marissa D Scott | Speech-Language Pathologist | 9732 Porcupine Path, Tomahawk, WI 54487-9366 | 2008-04-01 |
| 1992949028 | Erin Elizabeth Johnson-noble | Speech-Language Pathologist | 304 Kaphaem Rd, Tomahawk, WI 54487-7800 | 2009-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1659972982 | Patricia Theisen | Speech-Language Pathologist | 1515 Greenview Ave, Janesville, WI 53548-2800 | 2020-11-03 |
| 1487254108 | Samantha Lee Roberts | Speech-Language Pathologist | 3311 E Parkside Blvd Apt 125, Appleton, WI 54915-5631 | 2020-10-30 |
| 1134728751 | Mahwish Hashmi | Speech-Language Pathologist | 198 Caraway Pl, Sun Prairie, WI 53590-9537 | 2020-10-23 |
| 1891394508 | Lisa Kay Gaede | Speech-Language Pathologist | 424 River Dr, Black River Falls, WI 54615-9001 | 2020-10-22 |
| 1083213276 | Laura Swenson | Speech-Language Pathologist | 1922 State Road 87, Saint Croix Falls, WI 54024-7937 | 2020-10-20 |
| 1427656453 | Suzanne Q Hamilton | Speech-Language Pathologist | 2304 Hillcrest Dr, Janesville, WI 53545-4318 | 2020-10-12 |
| 1689272841 | Unbridled Abilities, LLC. | Speech-Language Pathologist | 1149 River Ridge Rd, River Falls, WI 54022-3412 | 2020-10-10 |
| 1104423490 | Tresa S Van Roo | Speech-Language Pathologist | W124 Us Highway 10, Mondovi, WI 54755-7837 | 2020-10-08 |
| 1538775531 | Haley Davidson | Speech-Language Pathologist | 960 S Rapids Rd # 4146, Manitowoc, WI 54220-4146 | 2020-09-16 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.