Individual provider Active NPI

Sydney Bojrab, MA, CCC-SLP

  • Speech-Language Pathologist
  • Livonia, MI
National Provider Identifier
1295202265
Registry record updated Nov 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101002935 Issued in MI
Practice address
36475 Five Mile Rd
Livonia, MI 48154-1971
Phone
(734) 655-2833
NPI assigned
Oct 29, 2018
Last updated
Nov 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 22004666A IN
Speech-Language Pathologist 235Z00000X 12121335 NU
Speech-Language Pathologist 235Z00000X 7101002935 MI 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

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22004666AINMDSpeech-Language Pathologist
7101002935MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1295202265",
    "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": "BOJRAB",
        "first_name": "SYDNEY",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004666A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": "12121335",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002935",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 13, 2018; 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.