Active NPI
Rachel Underwood
- Speech-Language Pathologist
- Flint, MI
National Provider Identifier
1174025704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101000525
- Practice address
- 5402 Gateway Ctr
Flint, MI 48507-3918 - Phone
- (810) 603-0040
- NPI assigned
- Feb 28, 2018
- Last updated
- Feb 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101000525 | MI | Primary |
Addresses
Primary practice location
5402 Gateway Ctr
Flint, MI 48507-3918
Mailing address
17187 N Laurel Park Dr Ste 160
Livonia, MI 48152-2692
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101000525 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221217000120 | MI | Practitioner - Qualified Speech Language Pathologist | 9931578796 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519776000000",
"number": "1174025704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17187 N LAUREL PARK DR STE 160",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481522692"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5402 GATEWAY CTR",
"city": "FLINT",
"state": "MI",
"postal_code": "485073918",
"telephone_number": "810-603-0040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "RACHEL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-02-28",
"last_updated": "2018-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101000525",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7101000525",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.