Individual provider Active NPI

Kristie Bauters, MS

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1033682638
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4201 Varsity Dr
Ann Arbor, MI 48108-5005
Phone
(734) 926-0740
NPI assigned
Jan 7, 2019
Last updated
May 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X NU Primary
Behavior Technician 106S00000X NU

Addresses

Primary practice location

4201 Varsity Dr
Ann Arbor, MI 48108-5005

Mailing address

28853 Lincolnview Dr
Farmington Hills, MI 48334-5253
Phone (810) 844-3989

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240702001632 MI Practitioner - Qualified Speech Language Pathologist 4385188218 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services, LLC Speech-Language Pathologist CurrentSince May 6, 2024 Accepting new patients
Creating Brighter Futures, Inc Speech-Language Pathologist Past Accepting new patients
Creating Brighter Futures Speech-Language Pathologist PastSince Oct 16, 2022 Accepting new patients

Organizations & group practices 3

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": "1546819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1033682638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28853 LINCOLNVIEW DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483345253",
            "telephone_number": "810-844-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 VARSITY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085005",
            "telephone_number": "734-926-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUTERS",
        "first_name": "KRISTIE",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-07",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.