Individual provider Active NPI

Theresa Ann Dahmer

  • Speech-Language Pathologist
  • Troy, MI
National Provider Identifier
1891308664
Registry record updated Aug 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101003775 Issued in MI
Practice address
5105 Somerton Dr
Troy, MI 48085-3252
Phone
(248) 229-9794
NPI assigned
Aug 31, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2020

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 7101003775 MI Primary

Addresses

Primary practice location

5105 Somerton Dr
Troy, MI 48085-3252

Mailing address

5105 Somerton Dr
Troy, MI 48085-3252
Phone (248) 229-9794

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7101003775MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Communicate Fully Speech-Language Pathologist CurrentSince Mar 12, 2023 Accepting new patients

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": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1891308664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 SOMERTON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853252",
            "telephone_number": "248-229-9794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5105 SOMERTON DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480853252",
            "telephone_number": "248-229-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHMER",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.