Individual provider Active NPI

Carson Gwizdz, M.A.

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1245976349
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7152000312 Issued in MI
Practice address
3200 W Liberty Rd Ste F
Ann Arbor, MI 48103-9180
Phone
(734) 369-6002
NPI assigned
May 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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 7152000312 MI Primary

Addresses

Primary practice location

3200 W Liberty Rd Ste F
Ann Arbor, MI 48103-9180

Mailing address

3073 Signature Blvd Apt H
Ann Arbor, MI 48103-6492
Phone (248) 228-0934

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 Arts

State licenses

LicenseStateTypeSpecialty
7152000312MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aa Therapy Works, LLC Speech-Language Pathologist CurrentSince May 12, 2023 Accepting new patients

Locations

3200 W Liberty Rd
Ste F
Ann Arbor, MI 48103
Phone (734) 369-6002

635 S Maple Rd
Ste 2
Ann Arbor, MI 48103
Phone (734) 369-6002

40500 Ann Arbor Rd E
Ste 200
Plymouth, MI 48170
Phone (734) 369-6002

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": "1652227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1245976349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3073 SIGNATURE BLVD APT H",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036492",
            "telephone_number": "248-228-0934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 W LIBERTY RD STE F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039180",
            "telephone_number": "734-369-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWIZDZ",
        "first_name": "CARSON",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152000312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.