Michele Rae Dykstra, MA-CCC, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

521 E Division St
Rockford, MI 49341-1376

Phone

(616) 866-6859

NPI assigned

Jul 10, 2018

Last updated

Jul 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Michigan State University College of Human Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Life Beyond Barriers RehabilitationGroup PAC ID 4880829738, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Life Beyond Barriers Rehabilitation

  • Physical Therapy Clinic/Center
  • Rockford, MI
  • NPI 1487087300
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1821584111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E DIVISION ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411376",
            "telephone_number": "616-866-6859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E DIVISION ST",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411376",
            "telephone_number": "616-866-6859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYKSTRA",
        "first_name": "MICHELE",
        "middle_name": "RAE",
        "credential": "MA-CCC, SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-10",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Renee Malinski Chiropractic PLLC (Rockford Chiropractic Clinic)
• Meranda A Drouin, RBT
• Bradley Theodore Dubey
• Gerald G Durfee, MD
• Brecken Elizabeth Durham
• Jeremy Norman Dzingle, D.M.D.
• Haley Anne Ecker, BT
• Nicole Jean Eddy, DPT
• Jonathan Jay Eggerichs, PSYD
• Elder Care of West Michigan PLLC

• Speech-Language Pathologist in Rockford, MI
• Providers in Rockford, 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 Jul 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.