Organization Active NPI

Huron Speech & Sensory Clinic PLLC

  • Speech-Language Pathologist
  • Bad Axe, MI
National Provider Identifier
1124578737
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
HURON SPEECH & SENSORY CLINIC PLLC
Practice address
128 W Huron Ave Ste H
Bad Axe, MI 48413-1177
Phone
(989) 269-7666
Fax
(989) 269-8234
NPI assigned
Oct 6, 2016
Last updated
Dec 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Authorized official

Name
Jessica Ruth
Title
Office Manager
Phone
(989) 269-7666

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 7101000089 MI
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

128 W Huron Ave Ste H
Bad Axe, MI 48413-1177

Mailing address

128 W Huron Ave Ste H
Bad Axe, MI 48413-1177
Phone (989) 269-7666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210311002095 MI Part B Supplier - Clinic/Group Practice 2163838475 Receives reassigned benefits from 2 practitioners
Practice locations: Bad Axe, MI

National Provider Directory

National Provider Directory

Locations

128 W Huron Ave
Ste H
Bad Axe, MI 48413
Phone (989) 269-6666

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670976000000",
    "number": "1124578737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W HURON AVE STE H",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131177",
            "telephone_number": "989-269-7666",
            "fax_number": "989-269-8234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W HURON AVE STE H",
            "city": "BAD AXE",
            "state": "MI",
            "postal_code": "484131177",
            "telephone_number": "989-269-7666",
            "fax_number": "989-269-8234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HURON SPEECH & SENSORY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A",
        "authorized_official_last_name": "RUTH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-269-7666"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000089",
            "primary": false
        },
        {
            "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 Bad Axe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.