Individual provider Active NPI

Elizabeth A. Fausone, MS,CCC,SLP

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1073845483
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
2050 Breton Rd SE Ste 107
Grand Rapids, MI 49546-5547
Phone
(616) 432-9059
Fax
(616) 226-5543
NPI assigned
Feb 10, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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 Primary

Addresses

Primary practice location

2050 Breton Rd SE Ste 107
Grand Rapids, MI 49546-5547

Mailing address

2050 Breton Rd SE Ste 107
Grand Rapids, MI 49546-5547
Phone (616) 822-6272

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000674 MI Practitioner - Qualified Speech Language Pathologist 3173792868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Voice Consultants, LLCGroup PAC ID 6608045372, 2 clinicians

Practice addresses (Care Compare)

2050 Breton Rd SE
Suite 107
Grand Rapids, MI 49546-5547
Phone (616) 822-6272

National Provider Directory

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

Organizations & group practices 1

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": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1073845483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 BRETON RD SE STE 107",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465547",
            "telephone_number": "616-822-6272",
            "fax_number": "616-226-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 BRETON RD SE STE 107",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465547",
            "telephone_number": "616-432-9059",
            "fax_number": "616-226-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSONE",
        "first_name": "ELIZABETH",
        "middle_name": "A.",
        "credential": "MS,CCC,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; 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.