NPIMap

Organization Active NPI

Purple Arch Neuro Rehabilitation, LLC

  • Speech-Language Pathologist
  • Macomb, MI
National Provider Identifier
1306460308
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PURPLE ARCH NEURO REHABILITATION, LLC
Practice address
53359 Champlain St
Macomb, MI 48042-3739
Phone
(586) 859-9607
NPI assigned
Jun 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Authorized official

Name
Dr. Thomas Laurie Southern Jr., SLPD
Title
Owner, Speech-Language Pathologist
Phone
(586) 859-9607

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

53359 Champlain St
Macomb, MI 48042-3739

Mailing address

53359 Champlain St
Macomb, MI 48042-3739
Phone (586) 859-9607

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1306460308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53359 CHAMPLAIN ST",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480423739",
            "telephone_number": "586-859-9607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53359 CHAMPLAIN ST",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480423739",
            "telephone_number": "586-859-9607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPLE ARCH NEURO REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "SOUTHERN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER, SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "586-859-9607",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "SLPD"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.