Individual provider Active NPI

Andrea E Bettis, CCC-SLP

  • Speech-Language Pathologist
  • Livonia, MI
National Provider Identifier
1942648209
Registry record updated Mar 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101000790 Issued in MI
Practice address
20000 Victor Pkwy Ste 100
Livonia, MI 48152-7027
Phone
(734) 743-2909
Fax
(734) 953-1743
NPI assigned
Jun 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2021

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 7101000790 MI Primary

Addresses

Primary practice location

20000 Victor Pkwy Ste 100
Livonia, MI 48152-7027

Mailing address

20000 Victor Pkwy Ste 100
Livonia, MI 48152-7027
Phone (734) 743-2909

Other practice location 1

600 Stephenson Hwy
Troy, MI 48083-1110
Phone (248) 616-4808 ext. 229

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140925001549 MI Practitioner - Qualified Speech Language Pathologist 1557581592 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Recovery Project, LLCGroup PAC ID 9739154311, 33 clinicians

Practice addresses (Care Compare)

11878 Hubbard St
Livonia, MI 48150-1733
Phone (734) 953-1745

15500 19 Mile Rd
Suite 330
Clinton TWP, MI 48038-6313
Phone (586) 412-0016

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7101000790MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Recovery Project, LLC Speech-Language Pathologist CurrentSince Feb 5, 2018 Accepting new patients
Resilire Neurorehabilitation PastSince May 17, 2021 Accepting new patients
Fare to Freedom PastSince Sep 15, 2019 Accepting new patients

Locations

11878 Hubbard St
Livonia, MI 48150
Phone (734) 953-1745

11878 Hubbard St
Ste 100
Livonia, MI 48150
Phone (734) 743-2909

20000 Victor Pkwy
Ste 100
Livonia, MI 48152
Phone (734) 743-2909

Organizations & group practices 3

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": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616284800000",
    "number": "1942648209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20000 VICTOR PKWY STE 100",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527027",
            "telephone_number": "734-743-2909",
            "fax_number": "734-953-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20000 VICTOR PKWY STE 100",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527027",
            "telephone_number": "734-743-2909",
            "fax_number": "734-953-1743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 Stephenson Hwy",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480831110",
            "country_code": "US",
            "telephone_number": "248-616-4808 x229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BETTIS",
        "first_name": "ANDREA",
        "middle_name": "E",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2021-03-21",
        "certification_date": "2021-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101000790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.