Individual provider Active NPI

Samantha Neirynck

  • Speech-Language Pathologist
  • Troy, MI
National Provider Identifier
1780059436
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101005693 Issued in MI
Practice address
600 Stephenson Hwy
Troy, MI 48083
Phone
(248) 951-4000
NPI assigned
Dec 7, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 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 7101005693 MI Primary

Addresses

Primary practice location

600 Stephenson Hwy
Troy, MI 48083

Mailing address

600 Stephenson Hwy
Troy, MI 48083-1110
Phone (248) 951-4000

Other practice location 1

3325 N University Dr
Coral Springs, FL 33065-4162
Phone (954) 344-6550

Other identifiers 1

IdentifierTypeStateIssuer
7101005693OtherMISPEECH-LANGUAGE PATHOLOGIST EDUCATIONAL LIMIT. LICENSE

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
Foundations Therapy, Inc. Past Accepting new patients
Foundations Therapy, Inc. PastSince Feb 6, 2022 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1780059436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 STEPHENSON HWY",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480831110",
            "telephone_number": "248-951-4000",
            "fax_number": "734-893-3195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 STEPHENSON HWY",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "248-951-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3325 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Coral Springs",
            "state": "FL",
            "postal_code": "330654162",
            "country_code": "US",
            "telephone_number": "954-344-6550",
            "fax_number": "954-344-8634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIRYNCK",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-07",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101005693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH-LANGUAGE PATHOLOGIST EDUCATIONAL LIMIT. LICENSE",
            "identifier": "7101005693",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.