Individual provider Active NPI

Megan Konwinski, MA CCC-SLP

  • Speech-Language Pathologist
  • Grand Rapids, MI
National Provider Identifier
1932639150
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101004814 Issued in MI
Practice address
459 Ivy Grove North NW
Grand Rapids, MI 49534-8725
Phone
(616) 826-6417
NPI assigned
Jun 20, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 7101004814 MI Primary

Addresses

Primary practice location

459 Ivy Grove North NW
Grand Rapids, MI 49534-8725

Mailing address

459 Ivy Grove North NW
Grand Rapids, MI 49534-8725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211002530 MI Practitioner - Qualified Speech Language Pathologist 5395271589

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Let'S Talk Speech Therapy LLC Single Specialty CurrentSince Sep 29, 2024 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": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1932639150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "459 IVY GROVE NORTH NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495348725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 IVY GROVE NORTH NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495348725",
            "telephone_number": "616-826-6417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONWINSKI",
        "first_name": "MEGAN",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-20",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101004814",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 May 8, 2023; 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.