Practical Rehabilitation Services, LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

PRACTICAL REHABILITATION SERVICES, LLC

Practice address

124 E Washington St Ste C
Dewitt, MI 48820-8826

Phone

(855) 777-9297

Fax

(517) 394-3604

NPI assigned

Oct 4, 2010

Last updated

Feb 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Amanda Marie Lake, MA-CCC-SLPNPI 1184954000

Title

Owner

Phone

(517) 282-7779

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 4

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.

• Amanda Marie Lake, MA CCC-SLP

  • Speech-Language Pathologist
  • Dewitt, MI
  • NPI 1184954000
  Medicare reassignment NPD Authorized official
• Corinne Hoedeman, SLP-CCC

  • Speech-Language Pathologist
  • Dewitt, MI
  • NPI 1558106310
  NPD
• Catharine Nagayda, MA, CCC-SLP

  • Speech-Language Pathologist
  • Dewitt, MI
  • NPI 1801106885
  NPD (past)
• Jodie Piper, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Macomb, MI
  • NPI 1407163850
  NPD (past)

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

{
    "created_epoch": "1286150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708300800000",
    "number": "1306155742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 794",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488050794",
            "telephone_number": "517-282-7779",
            "fax_number": "517-394-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E WASHINGTON ST STE C",
            "city": "DEWITT",
            "state": "MI",
            "postal_code": "488208826",
            "telephone_number": "855-777-9297",
            "fax_number": "517-394-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTICAL REHABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-04",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "LAKE",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-282-7779",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA-CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy's Speech Therapy LLC
• Sara B Peters, R.PH.
• Robin Phillips, PT
• Aryn Pierce, SLP
• Melissa Potter
• Ryan Matthew Raborn, PT
• Baraa Rad
• Stephanie M Radawiec, PT
• Muhammad Salman Rais
• Bruce Miller Reinoehl, M.D.

• Speech-Language Pathologist in Dewitt, MI
• Providers in Dewitt, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.