Individual provider Active NPI

Rachael Madison Iaquinto, M.A.

  • Speech-Language Pathologist
  • Fenton, MI
National Provider Identifier
1245887090
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101006469 Issued in MI
Practice address
10498 Carmer Rd
Fenton, MI 48430-2410
Phone
(248) 202-9061
NPI assigned
Aug 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 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 7101006469 MI Primary

Addresses

Primary practice location

10498 Carmer Rd
Fenton, MI 48430-2410

Mailing address

10498 Carmer Rd
Fenton, MI 48430-2410
Phone (248) 202-9061

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190912001266 MI Practitioner - Qualified Speech Language Pathologist 3678802899 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7101006469MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Language Crafters Speech-Language Pathologist CurrentSince Aug 1, 2024 Accepting new patients

Locations

202 W Shiawassee Ave
#114
Fenton, MI 48430
Phone (248) 780-9030

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1245887090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10498 CARMER RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302410",
            "telephone_number": "248-202-9061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10498 CARMER RD",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302410",
            "telephone_number": "248-202-9061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IAQUINTO",
        "first_name": "RACHAEL",
        "middle_name": "MADISON",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-26",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101006469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.