NPIMap

Organization Active NPI

Thrive Pediatric Speech and Feeding Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Grandville, MI
National Provider Identifier
1265074827
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THRIVE PEDIATRIC SPEECH AND FEEDING THERAPY, LLC
Practice address
2855 44TH St SW Ste 160
Grandville, MI 49418-2682
Phone
(616) 379-9887
NPI assigned
Oct 15, 2019
Last updated
Sep 19, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Meghan Vandewater, MA CCC-SLP, C/NDTNPI 1053953935
Title
Speech-Language Pathologist
Phone
(989) 370-3262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

2855 44TH St SW Ste 160
Grandville, MI 49418-2682

Mailing address

2855 44TH St SW Ste 160
Grandville, MI 49418-2682
Phone (616) 379-9887

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191213002136 MI Part B Supplier - Clinic/Group Practice 8325471873 Receives reassigned benefits from 5 practitioners
Practice locations: Grandville, MI

National Provider Directory

National Provider Directory

Locations

2855 44th St SW
Ste 160
Grandville, MI 49418
Phone (616) 379-9887

2250 28th St SW
Ste 2
Wyoming, MI 49519
Phone (616) 379-9887

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1571097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1265074827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 44TH ST SW STE 160",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182682",
            "telephone_number": "616-379-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 44TH ST SW STE 160",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182682",
            "telephone_number": "616-379-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE PEDIATRIC SPEECH AND FEEDING THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-15",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "VANDEWATER",
        "authorized_official_first_name": "MEGHAN",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "989-370-3262",
        "authorized_official_credential": "MA CCC-SLP, C/NDT"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.