Individual provider Active NPI

Michael Stewart Hanson

  • Speech-Language Pathologist
  • Holland, MI
National Provider Identifier
1871069765
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101007350 Issued in MI
Practice address
142 E 34TH St
Holland, MI 49423-7004
Phone
(914) 424-4094
NPI assigned
Oct 17, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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 7101007350 MI Primary

Addresses

Primary practice location

142 E 34TH St
Holland, MI 49423-7004

Mailing address

142 E 34TH St
Holland, MI 49423-7004
Phone (914) 424-4094

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
Theraplay, Inc. CurrentSince Dec 12, 2022 Accepting new patients

Locations

627 Elliott Ave
Grand Haven, MI 49417
Phone (231) 327-4252

2251 East Paris Ave SE
Grand Rapids, MI 49546
Phone (616) 447-7799

Organizations & group practices 1

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": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1871069765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 E 34TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237004",
            "telephone_number": "914-424-4094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 E 34TH ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237004",
            "telephone_number": "914-424-4094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "MICHAEL",
        "middle_name": "STEWART",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101007350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 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.

Verify at the official NPI Registry.