Individual provider Active NPI

Brianna L Vestal

  • Speech-Language Pathologist
  • Portage, MI
National Provider Identifier
1225964349
Registry record updated Jun 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7152001420 Issued in MI
Practice address
7864 Moorsbridge Rd
Portage, MI 49024-4424
Phone
(313) 278-4601
NPI assigned
Jun 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2026

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 7152001420 MI Primary

Addresses

Primary practice location

7864 Moorsbridge Rd
Portage, MI 49024-4424

Mailing address

31322 County Road 390 Apt a
Gobles, MI 49055-9324

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

NPI Registry JSON

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

{
    "created_epoch": "1781740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1225964349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31322 COUNTY ROAD 390 APT A",
            "city": "GOBLES",
            "state": "MI",
            "postal_code": "490559324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7864 MOORSBRIDGE RD",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490244424",
            "telephone_number": "313-278-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VESTAL",
        "first_name": "BRIANNA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-18",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152001420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; 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.