Active NPI
Nurture & Thrive LLC
- Speech-Language Pathologist
- Grand Rapids, MI
National Provider Identifier
1881453868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- Legal business name
- NURTURE & THRIVE LLC
- Practice address
- 1725 Boston St SE
Grand Rapids, MI 49506-4461 - Phone
- (786) 877-5679
- NPI assigned
- Mar 13, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jessica Evans, CCC-SLP
- Title
- Organizer
- Phone
- (786) 877-5679
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | Primary |
Addresses
Primary practice location
1725 Boston St SE
Grand Rapids, MI 49506-4461
Mailing address
1725 Boston St SE
Grand Rapids, MI 49506-4461
Phone (786) 877-5679
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659435964 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1729123200000",
"number": "1881453868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1725 BOSTON ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064461",
"telephone_number": "786-877-5679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1725 BOSTON ST SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064461",
"telephone_number": "786-877-5679"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NURTURE & THRIVE LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-03-13",
"last_updated": "2024-10-17",
"certification_date": "2024-10-17",
"status": "A",
"authorized_official_last_name": "EVANS",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "ORGANIZER",
"authorized_official_telephone_number": "786-877-5679",
"authorized_official_credential": "CCC-SLP"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1659435964",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.