Randi Michael Speech Pathology, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101001389 Issued in MI

Legal business name

RANDI MICHAEL SPEECH PATHOLOGY, LLC

Practice address

934 Eastgate CT
Frankenmuth, MI 48734-1246

Phone

(989) 598-0400

NPI assigned

Jan 18, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Randi Michael

Title

Owner

Phone

(989) 598-0400

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453075200000",
    "number": "1003273343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 EASTGATE CT",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341246",
            "telephone_number": "989-598-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 EASTGATE CT",
            "city": "FRANKENMUTH",
            "state": "MI",
            "postal_code": "487341246",
            "telephone_number": "989-598-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDI MICHAEL SPEECH PATHOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "RANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-598-0400"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.