Organization Active NPI

Nurture & Thrive LLC

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1881453868
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
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

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Jessica Evans, CCC-SLPNPI 1659435964
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)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
1659435964MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241106002469 MI Part B Supplier - Clinic/Group Practice 2062946577 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Practitioners & 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.

Verify at the official NPI Registry.