Individual provider Active NPI

Rosemarie Stavros Roberts, M.A., CCC-SLP

  • Speech-Language Pathologist
  • East Lansing, MI
National Provider Identifier
1972743524
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101003748 Issued in MI
Practice address
2775 East Lansing Drive
East Lansing, MI 48823
Phone
(517) 332-1616
NPI assigned
Feb 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 01030574 MI
Speech-Language Pathologist 235Z00000X 7101003748 MI Primary

Addresses

Primary practice location

2775 East Lansing Drive
East Lansing, MI 48823

Mailing address

2775 East Lansing Drive
East Lansing, MI 48823
Phone (517) 332-1616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090916000547 MI Practitioner - Qualified Speech Language Pathologist 5890841811 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01030574MIMDSpeech-Language Pathologist
7101003748MIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Network - Rehabilitation Services Speech-Language Pathologist CurrentSince Mar 1, 2019 Accepting new patients

Locations

2700 E Lansing Dr
East Lansing, MI 48823
Phone 5173321616 ext. 16205

2775 E Lansing Dr
East Lansing, MI 48823

2701 E Lansing Dr
East Lansing, MI 48823

2711 E Lansing Dr
East Lansing, MI 48823
Phone (517) 332-6932

1490 E Beltline Ave SE
Grand Rapids, MI 49506

5990 Venture Park Dr
Kalamazoo, MI 49009
Phone (269) 492-7842

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": "1235347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1972743524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2775 EAST LANSING DRIVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-332-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 EAST LANSING DRIVE",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "48823",
            "telephone_number": "517-332-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "ROSEMARIE",
        "middle_name": "STAVROS",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "01030574",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101003748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.