Jessica Sundholm

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7101001121 Issued in MI

Practice address

301 Williamston Center Rd.
Suite 800
Williamston, MI 48895

Phone

(517) 655-2327

Fax

(517) 655-2442

NPI assigned

May 23, 2016

Last updated

May 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Jessica Felker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

Practice roles

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.

• Grand Hearing Center LLC

  • Hearing Aid Equipment
  • Portland, MI
  • NPI 1437417409
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463961600000",
    "number": "1912354754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 E. GRAND RIVER AVE",
            "address_2": "SUITE B",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "48875",
            "telephone_number": "517-647-4327",
            "fax_number": "517-647-2442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 WILLIAMSTON CENTER RD.",
            "address_2": "SUITE 800",
            "city": "WILLIAMSTON",
            "state": "MI",
            "postal_code": "48895",
            "telephone_number": "517-655-2327",
            "fax_number": "517-655-2442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNDHOLM",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-23",
        "last_updated": "2016-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "FELKER",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James A Schaible
• Norma J Sell, LMSW ACSW
• Alys Marie Singleton, MSW
• Tracy Jo Smith
• Rachel Elizabeth Suggate, PHARM.D.
• Meghan Diane Suty, MA, LPC
• Erinna Toodzio, LLMSW
• Jacqueline Urban, LMSW
• Douglas R Vanderjagt, D.O.
• Wayne Charles Vaupel, ATC, NSCA-CPT

• Speech-Language Pathologist in Williamston, MI
• Providers in Williamston, MI by specialty
• Speech-Language Pathologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.