Organization Active NPI

Gro Speech LLC

  • Rehabilitation Clinic/Center
  • Bozeman, MT
National Provider Identifier
1679212179
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
GRO SPEECH LLC
Practice address
2075 Charlotte St Ste 1
Bozeman, MT 59718-2729
Phone
(860) 869-4997
NPI assigned
Jun 2, 2022
Last updated
Jan 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Authorized official

Name
Allegra Le, M.S., CCC-SLP
Title
Owner
Phone
(860) 869-4997

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing and Speech Clinic/Center 261QH0700X NU
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

2075 Charlotte St Ste 1
Bozeman, MT 59718-2729

Mailing address

2075 Charlotte St Ste 1
Bozeman, MT 59718-2729
Phone (860) 869-4997

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL fusionwebclinic.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250303002957 MT Part B Supplier - Clinic/Group Practice 6103347414 Receives reassigned benefits from 2 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

2075 Charlotte St
Ste 1
Bozeman, MT 59718
Phone (406) 556-9853

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1679212179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 CHARLOTTE ST STE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182729",
            "telephone_number": "860-869-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 CHARLOTTE ST STE 1",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597182729",
            "telephone_number": "860-869-4997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRO SPEECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ALLEGRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-869-4997",
        "authorized_official_credential": "M.S., CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "fusionwebclinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2075 Charlotte St Ste 1",
            "city": "Bozeman",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597182729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.