Individual provider Active NPI

Dawn Langejans

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1609400555
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101004067 Issued in MI
Practice address
100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560
Phone
(616) 486-6790
NPI assigned
Mar 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 24093 CA
Speech-Language Pathologist 235Z00000X 7101004067 MI Primary

Addresses

Primary practice location

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Mailing address

2121 Radcliff Ave SE
Grand Rapids, MI 49546-5767

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
7101004067MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1583020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1609400555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 RADCLIFF AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495465767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560",
            "telephone_number": "616-486-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGEJANS",
        "first_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-01",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "24093",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2020; 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.