Individual provider Active NPI

Sydney Knisley

  • Speech-Language Pathologist
  • West Bloomfield, MI
National Provider Identifier
1497500193
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101008939 Issued in MI
Practice address
5549 N Piccadilly
West Bloomfield, MI 48322-1443
Phone
(248) 735-8080
NPI assigned
Apr 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 7101008939 MI Primary

Addresses

Primary practice location

5549 N Piccadilly
West Bloomfield, MI 48322-1443

Mailing address

5549 N Piccadilly
West Bloomfield, MI 48322-1443

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240610003126 MI Practitioner - Qualified Speech Language Pathologist 4385186097 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101008939MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tmi East, Inc. CurrentSince May 14, 2025 Accepting new patients

Locations

851 Penniman Ave
Plymouth, MI 48170
Phone (248) 349-9595

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": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1497500193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5549 N PICCADILLY",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5549 N PICCADILLY",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483221443",
            "telephone_number": "248-735-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNISLEY",
        "first_name": "SYDNEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008939",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 3, 2024; 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.