Active NPI
Olivia Gray
- Speech-Language Pathologist
- Spring Lake, MI
National Provider Identifier
1902712425
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7152001542
- Practice address
- 17216 Van Wagoner Rd
Spring Lake, MI 49456-8705 - Phone
- (616) 402-6997
- NPI assigned
- Aug 24, 2026
- Last updated
- Aug 24, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
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 | 7152001542 | MI | Primary |
Addresses
Primary practice location
17216 Van Wagoner Rd
Spring Lake, MI 49456-8705
Mailing address
1125 Cambridge Dr SE
Grand Rapids, MI 49506-3317
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mi Floortime LLC | Speech-Language Pathologist | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1787529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787529600000",
"number": "1902712425",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1125 CAMBRIDGE DR SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495063317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17216 VAN WAGONER RD",
"city": "SPRING LAKE",
"state": "MI",
"postal_code": "494568705",
"telephone_number": "616-402-6997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-08-24",
"last_updated": "2026-08-24",
"certification_date": "2026-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7152001542",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spring Lake, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.