Individual provider Active NPI

Sophie Waldvogel

  • Speech-Language Pathologist
  • Grandville, MI
National Provider Identifier
1497611412
Registry record updated May 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7152001339 Issued in MI
Practice address
2880 Wilson Ave SW
Grandville, MI 49418-1221
Phone
(616) 300-5495
NPI assigned
Jan 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 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 7152001339 MI Primary

Addresses

Primary practice location

2880 Wilson Ave SW
Grandville, MI 49418-1221

Mailing address

3016 Knapp St NE
Grand Rapids, MI 49525-4513
Phone (231) 881-2941

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

State licenses

LicenseStateTypeSpecialty
7152001339MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Floortime LLC Speech-Language Pathologist CurrentSince Jan 4, 2026 Accepting new patients
Exemplary Speech Services Speech-Language Pathologist PastSince Aug 13, 2023 Accepting new patients

Locations

17216 Van Wagoner Rd
Spring Lake, MI 49456
Phone (231) 740-7812

Organizations & group practices 2

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": "1767398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778716800000",
    "number": "1497611412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 KNAPP ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495254513",
            "telephone_number": "231-881-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181221",
            "telephone_number": "616-300-5495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDVOGEL",
        "first_name": "SOPHIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-03",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152001339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; 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.