Individual provider Active NPI

Lindsay Reilly, MA, CCC-SLP

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1619442340
Registry record updated Oct 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101001201 Issued in MI
Practice address
2205 Commonwealth Blvd
Ann Arbor, MI 48105-2970
Phone
(734) 615-8475
NPI assigned
Oct 9, 2018
Last updated
Oct 9, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2018

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 7101001201 MI Primary

Addresses

Primary practice location

2205 Commonwealth Blvd
Ann Arbor, MI 48105-2970

Mailing address

11655 Brownell Ave
Plymouth, MI 48170-4408

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
7101001201MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1539043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539043200000",
    "number": "1619442340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11655 BROWNELL AVE",
            "city": "PLYMOUTH",
            "state": "MI",
            "postal_code": "481704408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2205 COMMONWEALTH BLVD",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052970",
            "telephone_number": "734-615-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "LINDSAY",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-09",
        "last_updated": "2018-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001201",
            "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 9, 2018; 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.