Individual provider Active NPI

Rachelle Bietler, CCC-SLP

  • Speech-Language Pathologist
  • Dearborn, MI
National Provider Identifier
1952851404
Registry record updated Oct 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101001177 Issued in MI
Practice address
23936 Michigan Ave
Dearborn, MI 48124-1833
Phone
(313) 278-4601
NPI assigned
Oct 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2016

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 7101001177 MI Primary

Addresses

Primary practice location

23936 Michigan Ave
Dearborn, MI 48124-1833

Mailing address

53087 Bayberry Dr
Macomb, MI 48042-2839
Phone (586) 419-1031

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

NPI Registry JSON

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

{
    "created_epoch": "1475884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475884800000",
    "number": "1952851404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53087 BAYBERRY DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480422839",
            "telephone_number": "586-419-1031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23936 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241833",
            "telephone_number": "313-278-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIETLER",
        "first_name": "RACHELLE",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-08",
        "last_updated": "2016-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101001177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.