Individual provider Active NPI

Terry Marie Anderson, SLP

  • Speech-Language Pathologist
  • Iron River, MI
National Provider Identifier
1003998915
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2149154 Issued in WI
Practice address
1400 W. Ice Lake Road
Iron River, MI 49935-4993
Phone
(906) 265-6121
NPI assigned
Oct 19, 2006
Last updated
Feb 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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 2149154 WI Primary

Addresses

Primary practice location

1400 W. Ice Lake Road
Iron River, MI 49935-4993

Mailing address

1400 W. Ice Lake Road
Iron River, MI 49935
Phone (906) 265-6121

Other identifiers 1

IdentifierTypeStateIssuer
42793400MedicaidWI

Other names 1

  • Mrs. Terry Marie Anderson Blanke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220818003259 MI Practitioner - Qualified Speech Language Pathologist 7113300492 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspirus KeweenawGroup PAC ID 8123912011, 116 clinicians

Practice addresses (Care Compare)

205 Osceola St
Laurium, MI 49913-2134
Phone (906) 337-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2149154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw CurrentSince May 18, 2022 Accepting new patients
Aspirus Keweenaw Current Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince May 18, 2022 Accepting new patients
Aspirus Keweenaw CurrentSince May 18, 2022 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. CurrentSince May 18, 2022 Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince May 18, 2022 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. CurrentSince May 18, 2022 Accepting new patients
Aspirus Ironwood Hospital & Clinics, Inc. Current Accepting new patients
Aspirus Iron River Hospital & Clinics, Inc. Past Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1328 US Highway 2
Crystal Falls, MI 49920
Phone (906) 774-8110

1000 Cedar St
Houghton, MI 49931
Phone (906) 482-8201

1400 W Ice Lake Rd
Iron River, MI 49935
Phone (906) 265-6121

814 S Ice Lake Rd
Iron River, MI 49935
Phone (715) 847-2022

N10565 Grandview Ln
Ironwood, MI 49938
Phone (906) 932-1500

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

601 S 7th St
Ontonagon, MI 49953
Phone (906) 884-8000

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1003998915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W. ICE LAKE ROAD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "49935",
            "telephone_number": "906-265-6121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W. ICE LAKE ROAD",
            "city": "IRON RIVER",
            "state": "MI",
            "postal_code": "499354993",
            "telephone_number": "906-265-6121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "TERRY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2149154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42793400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRY",
            "last_name": "ANDERSON BLANKE",
            "middle_name": "MARIE",
            "prefix": "MRS.",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Iron River, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.