NPIMap

Organization Active NPI

Pediatric Speech Services LLC

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1487005807
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PEDIATRIC SPEECH SERVICES LLC
Practice address
2471 Forest Meadows CT SE
Grand Rapids, MI 49546-7931
Phone
(616) 291-9762
NPI assigned
Jun 27, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Authorized official

Name
Jill MillerNPI 1952563017
Title
Owner
Phone
(616) 291-9762

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2471 Forest Meadows CT SE
Grand Rapids, MI 49546-7931

Mailing address

2471 Forest Meadows CT SE
Grand Rapids, MI 49546-7931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160719002093 MI Part B Supplier - Clinic/Group Practice 9032402615 Receives reassigned benefits from 5 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754524800000",
    "number": "1487005807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2471 FOREST MEADOWS CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2471 FOREST MEADOWS CT SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495467931",
            "telephone_number": "616-291-9762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SPEECH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-27",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-291-9762"
    },
    "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 Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; 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.