Ajay Gupta, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

12080163 Issued in MI

Practice address

25865 W 12 Mile Rd
Southfield, MI 48034-1817

Phone

(248) 208-7492

NPI assigned

Sep 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Regain Therapy Services LLC

  • Physical Therapist
  • Clarkston, MI
  • NPI 1255043196

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1487803466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-208-7492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25865 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341817",
            "telephone_number": "248-208-7492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AJAY",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "12080163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASHA#",
            "identifier": "12080163",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarada Gullapalli, M.D.
• Naomi Gulley
• Jerlene Cewonia Gunn
• Stephen Jerome Gunther, MD
• Qingyu Guo, DO
• Anu Gupta, OD
• Nitin Kumar Gupta, MD
• Rashmi Gupta, MD
• Rishita Gupta, DO
• Jamilia Gupton

• Speech-Language Pathologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.