Active NPI
Susan Coon
- Speech-Language Pathologist
- Saint Clair Shores, MI
National Provider Identifier
1811565245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101002323
- Practice address
- 19631 Ridgemont St
Saint Clair Shores, MI 48080-3320 - Phone
- (248) 705-6027
- NPI assigned
- Jun 13, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 | 7101002323 | MI | Primary |
Addresses
Primary practice location
19631 Ridgemont St
Saint Clair Shores, MI 48080-3320
Mailing address
19631 Ridgemont St
Saint Clair Shores, MI 48080-3320
Phone (248) 705-6027
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 2487056027 | ||
| Other URL | 2487056027 | ||
| FHIR URL | 2487056027 |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101002323 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623542400000",
"number": "1811565245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19631 RIDGEMONT ST",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480803320",
"telephone_number": "248-705-6027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19631 RIDGEMONT ST",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480803320",
"telephone_number": "248-705-6027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COON",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-13",
"last_updated": "2021-06-13",
"certification_date": "2021-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101002323",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "2487056027",
"affiliation": "N",
"address_1": "19631 Ridgemont St",
"city": "Saint Clair Shores",
"state": "MI",
"country_code": "US",
"postal_code": "480803320",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "2487056027",
"affiliation": "N",
"address_1": "19631 Ridgemont St",
"city": "Saint Clair Shores",
"state": "MI",
"country_code": "US",
"postal_code": "480803320",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "2487056027",
"affiliation": "N",
"address_1": "19631 Ridgemont St",
"city": "Saint Clair Shores",
"state": "MI",
"country_code": "US",
"postal_code": "480803320",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Saint Clair Shores, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.