Individual provider Active NPI

Susan Leslie McGraw

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1194298315
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101000856 Issued in MI
Practice address
2589 44TH St SE
Grand Rapids, MI 49512-3877
Phone
(616) 643-2564
Fax
(616) 643-2539
NPI assigned
Jan 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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 7101000856 MI Primary

Addresses

Primary practice location

2589 44TH St SE
Grand Rapids, MI 49512-3877

Mailing address

2310 Pleasant Pond Dr SW
Byron Center, MI 49315-8488
Phone (616) 719-7720

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7101000856MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1194298315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 PLEASANT POND DR SW",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158488",
            "telephone_number": "616-719-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2589 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495123877",
            "telephone_number": "616-643-2564",
            "fax_number": "616-643-2539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRAW",
        "first_name": "SUSAN",
        "middle_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000856",
            "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 Jan 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.