Individual provider Active NPI

Erin Beeker, CCC-SLP

  • Speech-Language Pathologist
  • West Bloomfield, MI
National Provider Identifier
1356891691
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101005945 Issued in MI
Practice address
6625 Daly Rd
West Bloomfield, MI 48322-3410
Phone
(248) 737-3430
NPI assigned
Oct 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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 22006691A IN
Speech-Language Pathologist 235Z00000X 46003081A IN
Speech-Language Pathologist 235Z00000X 7101005945 MI Primary

Addresses

Primary practice location

6625 Daly Rd
West Bloomfield, MI 48322-3410

Mailing address

6625 Daly Rd
West Bloomfield, MI 48322-3410
Phone (248) 737-3430

Other practice location 1

205 N Tillotson Ave
Room Rehab
Muncie, IN 47304-3900
Phone (765) 289-1928

Other identifiers 1

IdentifierTypeStateIssuer
201395050MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190308000778 MI Practitioner - Qualified Speech Language Pathologist 0840539870 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22006691AINMDSpeech-Language Pathologist
46003081AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kaufman Children'S Center PastSince Oct 1, 2018 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1356891691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6625 DALY RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483223410",
            "telephone_number": "248-737-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 N Tillotson Ave",
            "address_2": "Room Rehab",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473043900",
            "country_code": "US",
            "telephone_number": "765-289-1928",
            "fax_number": "765-741-0335",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEEKER",
        "first_name": "ERIN",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-11",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22006691A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "46003081A",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201395050",
            "state": "IN"
        }
    ],
    "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 Feb 14, 2019; 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.