Individual provider Active NPI

Kelly M McGuire, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Whitmore Lake, MI
National Provider Identifier
1003103375
Registry record updated Jul 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12145015 Issued in MI
Practice address
11930 Whitmore Lake Rd
Suite L-M
Whitmore Lake, MI 48189-9153
Phone
(734) 449-4649
NPI assigned
Jul 6, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2011

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 12145015 MI Primary

Addresses

Primary practice location

11930 Whitmore Lake Rd
Suite L-M
Whitmore Lake, MI 48189-9153

Mailing address

3077 Signature Blvd
Apt. B
Ann Arbor, MI 48103-6927
Phone (949) 233-1982

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12145015MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309910400000",
    "number": "1003103375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3077 SIGNATURE BLVD",
            "address_2": "APT. B",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036927",
            "telephone_number": "949-233-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 WHITMORE LAKE RD",
            "address_2": "SUITE L-M",
            "city": "WHITMORE LAKE",
            "state": "MI",
            "postal_code": "481899153",
            "telephone_number": "734-449-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "KELLY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2011-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12145015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitmore Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.