Organization Active NPI

South Shore Speech LLC

  • Speech-Language Pathologist
  • Battle Creek, MI
National Provider Identifier
1003898123
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SOUTH SHORE SPEECH LLC
Practice address
395 S Shore Dr
Suite 310
Battle Creek, MI 49015-4466
Phone
(269) 660-1025
Fax
(269) 660-1588
NPI assigned
Nov 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Peggy M Wray, MA CCC SLP
Title
Speech Language Pathologist
Phone
(269) 660-1025

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

395 S Shore Dr
Suite 310
Battle Creek, MI 49015-4466

Mailing address

395 S Shore Dr
Suite 310
Battle Creek, MI 49015-4466
Phone (269) 660-1025

National Provider Directory

National Provider Directory

Locations

395 S Shore Dr
Ste 310
Battle Creek, MI 49014
Phone (269) 660-1025

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003898123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 S SHORE DR",
            "address_2": "SUITE 310",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154466",
            "telephone_number": "269-660-1025",
            "fax_number": "269-660-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 S SHORE DR",
            "address_2": "SUITE 310",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154466",
            "telephone_number": "269-660-1025",
            "fax_number": "269-660-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WRAY",
        "authorized_official_first_name": "PEGGY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SPEECH LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "269-660-1025",
        "authorized_official_credential": "MA CCC SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.