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MRS. CARLY CAROLYN NIELSEN CCC-SLP
NPI 1427543040
Speech-Language Pathologist in Eau Claire, WI

Active since June 26, 2018Accepts Medicare Assignment
1400 BELLINGER ST, EAU CLAIRE, WI 54703(715) 838-5222 Get Directions Write a Review

NPPES record last updated: September 8, 2021. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Sep 8, 2021, Sep 15, 2020, Dec 2, 2019 and 2 more (5 updates tracked since 2018).

About Mrs. Carly Carolyn Nielsen Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. CARLY CAROLYN NIELSEN CCC-SLP (NPI 1427543040) is an individual speech-language pathologist provider in Eau Claire, Wisconsin, licensed in Wisconsin (4687154) and active in the NPI registry since June 2018. She maintains a secondary practice location in Menomonie and is a graduate of Other (2018).

NPPES Registry Identity

NPI1427543040
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameMRS. CARLY CAROLYN NIELSENCredential: CCC-SLP
Location Address1400 BELLINGER STEau Claire, WI 54703-5222
Mailing AddressPo Box 1510Eau Claire, WI 54702-1510 · (715) 838-5222
Phone(715) 838-5222
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateJune 26, 2018
Last NPPES UpdateSeptember 8, 20215 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2021
✔ NPI 1427543040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in WI · 4687154
Definition
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.
1400 BELLINGER ST, Eau Claire, WI 54703
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Other Names 1

Former Name (1)Miss Carly Carolyn Kjornes

Secondary Practice Location 1

Location 12321 Stout RdMenomonie, WI 54751 · Phone (715) 235-9671

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Carly Carolyn Nielsen Ccc-slp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID143559237
PECOS Enrollment IDI20251017000042

Medicare Billing Reassignment

Medicare enrollment records show Carly Nielsen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Empowerme Rehabilitation, LLC
1,334 mi
Multi-Specialty
9000 E SAN VICTOR DR
Scottsdale, AZ 85258
  • Reassigned Medicare billing, Arizona enrollment
  • 106 clinicians in this Medicare group
NPI 1144954074 (877) 367-9772

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELLEN A CHRISTENSEN OT
Occupational Therapist
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
JESSICA ERIN ROETS OT
Occupational Therapist
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
SUZANNE M STEWART LPC
Counselor (Professional)
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
KATHRYN LEIGH OLSON MHA, RD, LDN,CDE
Dietitian, Registered
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
CAMILLA MICHELLE NELSON MD
Pediatrics
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
SARAH HOTOVY MD
Family Medicine
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-3311
JADE ELLIE JEHN
Occupational Therapist
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222
ANDREA AGUAYO PHARMD
Pharmacist
1400 BELLINGER ST
EAU CLAIRE, WI 54703
Eau Claire County (715) 838-5222

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carly Nielsen's NPI number?

The NPI number for Carly Nielsen is 1427543040. It was assigned to this individual provider in the NPPES registry on June 26, 2018. The provider is also known as Miss Carly Carolyn Kjornes.

Where is Carly Nielsen located?

Carly Nielsen practices at 1400 Bellinger St, Eau Claire, WI 54703. The listed phone number is (715) 838-5222.

What is Carly Nielsen's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Carly Nielsen enrolled in Medicare?

Yes. Carly Nielsen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Carly Nielsen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carly Nielsen reassigns Medicare benefits to Empowerme Rehabilitation, LLC (Scottsdale, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carly Nielsen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Carly Nielsen was last updated on September 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.