Active NPI
Samuel Moses, M.A., CCC-SLP
- Speech-Language Pathologist
- Farmington Hills, MI
National Provider Identifier
1679282420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101006367
- Practice address
- 28050 Grand River Ave
Farmington Hills, MI 48336-5919 - Phone
- (947) 521-8141
- Fax
- (248) 471-8781
- NPI assigned
- Nov 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101006367 | MI | Primary |
Addresses
Primary practice location
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Mailing address
28050 Grand River Ave
Farmington Hills, MI 48336-5919
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7101006367 | Medicaid | MI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | EPIC | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7101006367 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1668988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1679282420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919",
"fax_number": "248-471-8781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28050 GRAND RIVER AVE",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483365919",
"telephone_number": "947-521-8141",
"fax_number": "248-471-8781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSES",
"first_name": "SAMUEL",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-11-21",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101006367",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7101006367",
"state": "MI"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "EPIC",
"affiliation": "N",
"endpointDescription": "centralized electronic medical records system",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "28050 Grand River Ave",
"city": "Farmington Hills",
"state": "MI",
"country_code": "US",
"postal_code": "483365919",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.