Individual provider Active NPI

Stacy Pelon, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Holland, MI
National Provider Identifier
1447726138
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101004428 Issued in MI
Practice address
720 E 8TH St Ste 3
Holland, MI 49423-3079
Phone
(616) 300-5495
NPI assigned
Oct 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101004428 MI Primary

Addresses

Primary practice location

720 E 8TH St Ste 3
Holland, MI 49423-3079

Mailing address

2880 Wilson Ave SW
Grandville, MI 49418-1221
Phone (616) 300-5495

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210810003447 MI Practitioner - Qualified Speech Language Pathologist 1153725346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7101004428MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Apr 30, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Apr 30, 2023 Accepting new patients
Exemplary Speech Services Speech-Language Pathologist PastSince Aug 13, 2023 Accepting new patients

Locations

2929 Nazareth Rd
Kalamazoo, MI 49048
Phone (269) 213-8352

Organizations & group practices 3

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": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785974400000",
    "number": "1447726138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181221",
            "telephone_number": "616-300-5495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E 8TH ST STE 3",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233079",
            "telephone_number": "616-300-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELON",
        "first_name": "STACY",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; 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.