Active NPI
Katlin Gruden
- Speech-Language Pathologist
- West Bloomfield, MI
National Provider Identifier
1902680259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7152000693
- Practice address
- 7001 Orchard Lake Rd
West Bloomfield, MI 48322-3604 - Phone
- (313) 278-4601
- NPI assigned
- Aug 18, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7152000693 | MI | Primary |
Addresses
Primary practice location
7001 Orchard Lake Rd
West Bloomfield, MI 48322-3604
Mailing address
3150 Woodward Ave Apt 436
Detroit, MI 48201-2752
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7152000693 | MI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridges Spectrum Therapy LLC. | Multi-Specialty | Past | 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": "1692316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692316800000",
"number": "1902680259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3150 WOODWARD AVE APT 436",
"city": "DETROIT",
"state": "MI",
"postal_code": "482012752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7001 ORCHARD LAKE RD",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483223604",
"telephone_number": "313-278-4601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUDEN",
"first_name": "KATLIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-18",
"last_updated": "2023-08-18",
"certification_date": "2023-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7152000693",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Bloomfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.