Active NPI
Kristine Fairman
- Speech-Language Pathologist
- Westland, MI
National Provider Identifier
1609157114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101004251
- Practice address
- 528 Ethan Dr
Westland, MI 48185-9642 - Phone
- (586) 943-1938
- NPI assigned
- Aug 30, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA10746 | FL | |
| Speech-Language Pathologist | 235Z00000X | 7101004251 | MI | Primary |
Addresses
Primary practice location
528 Ethan Dr
Westland, MI 48185-9642
Mailing address
528 Ethan Dr
Westland, MI 48185-9642
Phone (586) 943-1938
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA10746 | FL | MD | Speech-Language Pathologist |
| 7101004251 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1314662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454630400000",
"number": "1609157114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "528 ETHAN DR",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481859642",
"telephone_number": "586-943-1938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "528 ETHAN DR",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481859642",
"telephone_number": "586-943-1938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRMAN",
"first_name": "KRISTINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-30",
"last_updated": "2016-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA10746",
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101004251",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.