Erin N Heator-Dietsche, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101005202

Practice address

2880 Wilson Ave SW
Grandville, MI 49418-1221

Phone

(616) 300-5495

Fax

(616) 469-1464

NPI assigned

Feb 16, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Exemplary Speech Services

  • Speech-Language Pathologist
  • Grandville, MI
  • NPI 1962144782
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1710632914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181221",
            "telephone_number": "616-300-5495",
            "fax_number": "616-469-1464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 WILSON AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494181221",
            "telephone_number": "616-300-5495",
            "fax_number": "616-469-1464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATOR-DIETSCHE",
        "first_name": "ERIN",
        "middle_name": "N",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "710005202",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "7101005202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Grandville, MI
• Providers in Grandville, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.