Individual provider Active NPI

Maya Rooks

  • Speech-Language Pathologist
  • Caledonia, MI
National Provider Identifier
1205700341
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101009663 Issued in MI
Practice address
9809 Cherry Valley Ave SW
Suite D
Caledonia, MI 49316
Phone
(616) 536-2211
NPI assigned
Oct 1, 2025
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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 7101009663 MI Primary

Addresses

Primary practice location

9809 Cherry Valley Ave SW
Suite D
Caledonia, MI 49316

Mailing address

9809 Cherry Valley Ave SW
Suite D
Caledonia, MI 49316
Phone (218) 929-9595

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251219001433 MI Practitioner - Qualified Speech Language Pathologist 3375038045 Reassigns benefits to 1 organization

Care Compare profile

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

Practice addresses (Care Compare)

777 Goguac St W
Suite B2
Springfield, MI 49015-2097

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101009663MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Kids Therapy Center LLC Speech-Language Pathologist CurrentSince Oct 13, 2025 Accepting new patients

Locations

777 Goguac St W
Ste B2
Springfield, MI 49015
Phone (269) 223-7786

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1205700341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9809 CHERRY VALLEY AVE SW",
            "address_2": "SUITE D",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "49316",
            "telephone_number": "218-929-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9809 CHERRY VALLEY AVE SW",
            "address_2": "SUITE D",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "49316",
            "telephone_number": "616-536-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROOKS",
        "first_name": "MAYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-01",
        "last_updated": "2025-10-01",
        "certification_date": "2025-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101009663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 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.