Individual provider Active NPI

Heather Lea Fyall, SLP

  • Speech-Language Pathologist
  • Ann Arbor, MI
National Provider Identifier
1659005718
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
4201 Varsity Dr
Ann Arbor, MI 48108-5005
Phone
(734) 926-0740
Fax
(734) 369-8851
NPI assigned
Jul 14, 2022
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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 MI Primary

Addresses

Primary practice location

4201 Varsity Dr
Ann Arbor, MI 48108-5005

Mailing address

4201 Varsity Dr
Ann Arbor, MI 48108-5005

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Brighter Futures CurrentSince Jul 15, 2022 Accepting new patients
Creating Brighter Futures Speech-Language Pathologist CurrentSince Oct 16, 2022 Accepting new patients

Locations

4201 Varsity Dr
Ann Arbor, MI 48108
Phone (734) 926-0740

4201 Varsity Dr
Ste C
Ann Arbor, MI 48108
Phone (734) 926-0740

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1659005718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 VARSITY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 VARSITY DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085005",
            "telephone_number": "734-926-0740",
            "fax_number": "734-369-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FYALL",
        "first_name": "HEATHER",
        "middle_name": "LEA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": null,
            "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 Jul 14, 2022; 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.