Individual provider Active NPI

Ahlam A Issa

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1568950244
Registry record updated Oct 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7151001569 Issued in MI
Practice address
2291 Shadowood Dr
Ann Arbor, MI 48108-2543
Phone
(734) 945-9628
NPI assigned
Apr 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2021

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 7151001569 MI Primary

Addresses

Primary practice location

2291 Shadowood Dr
Ann Arbor, MI 48108-2543

Mailing address

2291 Shadowood Dr
Ann Arbor, MI 48108-2543
Phone (734) 945-9628

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180621000180 MI Practitioner - Qualified Speech Language Pathologist 5597010298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2900 Golfside Dr
Suite 6
Ann Arbor, MI 48108-1410
Phone (734) 224-9121

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7151001569MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Issa Speech Therapy PLLC CurrentSince Sep 30, 2021 Accepting new patients

Locations

2900 Golfside Dr
Ste 6
Ann Arbor, MI 48108
Phone (734) 224-9121

5245 Schaefer Rd
Ste D
Dearborn, MI 48126
Phone (248) 862-5311

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1568950244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 SHADOWOOD DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082543",
            "telephone_number": "734-945-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 SHADOWOOD DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481082543",
            "telephone_number": "734-945-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISSA",
        "first_name": "AHLAM",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7151001569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.