Individual provider Active NPI

Jordan Gopi Nagaruri

  • Speech-Language Pathologist
  • Ypsilanti, MI
National Provider Identifier
1033708953
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101009540 Issued in MI
Practice address
850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594
Phone
(734) 544-5561
Fax
(734) 527-5981
NPI assigned
Jan 14, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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 7101009540 MI Primary

Addresses

Primary practice location

850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594

Mailing address

850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594
Phone (734) 544-5561

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251003003911 MI Practitioner - Qualified Speech Language Pathologist 3971009200

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2156 Lakeview Dr
Apt 260
Ypsilanti, MI 48198-6738

850 S Hewitt Rd
Suite 100
Ypsilanti, MI 48197-4594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101009540MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Autism Centers LLC Speech-Language Pathologist CurrentSince Jul 31, 2025 Accepting new patients
Arbor Autism Pediatric Medical Centers PLLC CurrentSince Oct 5, 2025 Accepting new patients

Locations

850 S Hewitt Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 544-5561

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1033708953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S HEWITT RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974594",
            "telephone_number": "734-544-5561",
            "fax_number": "734-527-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S HEWITT RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974594",
            "telephone_number": "734-544-5561",
            "fax_number": "734-527-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOPI NAGARURI",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-14",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101009540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; 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.