Individual provider Active NPI

Tiffany Ann Chappell, M.A. SPEECH PATHOLOG

  • Speech-Language Pathologist
  • Bay City, MI
National Provider Identifier
1457733768
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101000761 Issued in MI
Practice address
2535 22ND St
Bay City, MI 48708-7612
Phone
(989) 891-9900
Fax
(989) 891-0800
NPI assigned
Jun 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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 7101000761 MI Primary

Addresses

Primary practice location

2535 22ND St
Bay City, MI 48708-7612

Mailing address

2535 22ND St
Bay City, MI 48708-7612
Phone (989) 891-9900

Other identifiers 1

IdentifierTypeStateIssuer
235Z00000XMedicaidMI

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)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7101000761MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Paramount Rehabilitation Services, PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1457733768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2535 22ND ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087612",
            "telephone_number": "989-891-9900",
            "fax_number": "989-891-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2535 22ND ST",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487087612",
            "telephone_number": "989-891-9900",
            "fax_number": "989-891-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPPELL",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.A. SPEECH PATHOLOG",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-23",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "235Z00000X",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.