Individual provider Active NPI

Philip Menard, CCC-SLP

  • Speech-Language Pathologist
  • Ypsilanti, MI
National Provider Identifier
1225321763
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101003147 Issued in MI
Practice address
850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594
Phone
(734) 544-5561
Fax
(734) 527-5981
NPI assigned
May 17, 2011
Last updated
May 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 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 7101003147 MI Primary

Addresses

Primary practice location

850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594

Mailing address

850 S Hewitt Rd Ste 100
Ypsilanti, MI 48197-4594
Phone (734) 544-5561

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101003147MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Arbor Autism Centers Allied Health LLC Speech-Language Pathologist Current Accepting new patients
Arbor Autism Pediatric Medical Centers PLLC CurrentSince May 7, 2023 Accepting new patients

Locations

850 S Hewitt Rd
Ste 100
Ypsilanti, MI 48197
Phone (734) 544-5561

Interoperability endpoints

  • Direct secure messaging: arborautism.philipmenard@150980.advancedmd-direct.com

Organizations & group practices 3

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": "1305590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1225321763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S HEWITT RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974594",
            "telephone_number": "734-544-5561",
            "fax_number": "734-527-5981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S HEWITT RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481974594",
            "telephone_number": "734-544-5561",
            "fax_number": "734-527-5981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENARD",
        "first_name": "PHILIP",
        "name_prefix": "Mr.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-17",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.