Individual provider Active NPI

Olivia Baker, SLP

  • Speech-Language Pathologist
  • Grandville, MI
National Provider Identifier
1811613896
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101008209 Issued in MI
Practice address
2880 Wilson Ave SW
Grandville, MI 49418-1221
Phone
(616) 300-5495
NPI assigned
Oct 12, 2022
Last updated
Jan 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 7101008209 MI Primary

Addresses

Primary practice location

2880 Wilson Ave SW
Grandville, MI 49418-1221

Mailing address

804 Chatham St NW
Grand Rapids, MI 49504-5659
Phone (248) 622-0689

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL rockfordspeechtherapy.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221026002987 MI Practitioner - Qualified Speech Language Pathologist 7517333982 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Rehabilitation Services, LLC Speech-Language Pathologist CurrentSince Feb 1, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1811613896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 CHATHAM ST NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045659",
            "telephone_number": "248-622-0689"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKER",
        "first_name": "OLIVIA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-12",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101008209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "rockfordspeechtherapy.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "117 Courtland St",
            "city": "Rockford",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493411031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.