Individual provider Active NPI

Nina Petrykowski

  • Speech-Language Pathologist
  • Macomb, MI
National Provider Identifier
1548106958
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7152001350 Issued in MI
Practice address
19550 Potomac Dr
Macomb, MI 48044-4234
Phone
(586) 484-0870
NPI assigned
Apr 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 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 7152001350 MI Primary

Addresses

Primary practice location

19550 Potomac Dr
Macomb, MI 48044-4234

Mailing address

19550 Potomac Dr
Macomb, MI 48044-4234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians

Practice addresses (Care Compare)

1055 Forest Hill Ave SE
Grand Rapids, MI 49546-3626
Phone (616) 726-8595

2885 10 Mile Rd NE
Rockford, MI 49341-9100
Phone (616) 326-0010

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7152001350MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1548106958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19550 POTOMAC DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19550 POTOMAC DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480444234",
            "telephone_number": "586-484-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRYKOWSKI",
        "first_name": "NINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7152001350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.