Active NPI
Alexandra Kedzior
- Speech-Language Pathologist
- West Bloomfield, MI
National Provider Identifier
1346807609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101004815
- Practice address
- 5549 N Piccadilly
West Bloomfield, MI 48322-1443 - Phone
- (248) 735-8080
- NPI assigned
- May 22, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101004815 | MI | Primary |
Addresses
Primary practice location
5549 N Piccadilly
West Bloomfield, MI 48322-1443
Mailing address
5549 N Piccadilly
West Bloomfield, MI 48322-1443
Other practice location 1
8755 Aero Dr Ste 100
San Diego, CA 92123-1750
Phone (619) 578-2232
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101004815 | MI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healing Haven, LLC | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Developmental Disabilities Clinic/Center
- Madison Heights, MI
- NPI 1790110187
Speech-Language Pathologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679270400000",
"number": "1346807609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5549 N PICCADILLY",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483221443"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5549 N PICCADILLY",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483221443",
"telephone_number": "248-735-8080"
}
],
"practiceLocations": [
{
"address_1": "8755 Aero Dr Ste 100",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921231750",
"country_code": "US",
"telephone_number": "619-578-2232",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KEDZIOR",
"first_name": "ALEXANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-22",
"last_updated": "2023-03-20",
"certification_date": "2023-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101004815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.