Active NPI
Elizabeth Anne Koster, MS/CF SLPR
- Speech-Language Pathologist
- Livonia, MI
National Provider Identifier
1235305913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3017154
- Practice address
- 36475 Five Mile Rd
Livonia, MI 48154-1971 - Phone
- (734) 655-2833
- NPI assigned
- May 2, 2008
- Sex
- Female
- Sole proprietor
- No
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 | 3017154 | WI | Primary |
Addresses
Primary practice location
36475 Five Mile Rd
Livonia, MI 48154-1971
Mailing address
36475 Five Mile Rd
Livonia, MI 48154-1971
Phone (734) 655-2833
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42590900 | Medicaid | WI |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3017154 | WI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1235305913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36475 FIVE MILE RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541971",
"telephone_number": "734-655-2833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36475 FIVE MILE RD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "481541971",
"telephone_number": "734-655-2833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOSTER",
"first_name": "ELIZABETH",
"middle_name": "ANNE",
"credential": "MS/CF SLPR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-02",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "WI",
"license": "3017154",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42590900",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.