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Kelli Van Der Heide

Speech-Language Pathologist β€’ Ada, MI

Active NPI 1134523020 Individual Practitioner Female Practitioner
Practice location in NPPES

4670 Fulton St E Ste 201
Ada, MI 493018409

Call 6165912905 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

4670 Fulton St E Ste 201

Ada, MI 493018409

Telephone 6165912905
Organization at the Same NPPES Address or Phone
Paper Plane Therapies, Llc Facility NPI 1073975645

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2014

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Kelli Van Der Heide has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Compared with the same specialty in Ada and Michigan

5 active clinicians are listed under Speech-Language Pathologist with a practice address in Ada, MI (3,736 in Michigan).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-09-15
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

License # reported to NPPES MI 7101004541

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Michigan Department of Licensing and Regulatory Affairs.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - QUALIFIED SPEECH LANGUAGE PATHOLOGIST

Medicare Enrollment ID

I20141208002186

Enrollment State Jurisdiction

MI

PECOS Control ID

4789906462

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location September 15, 2025

Registered at 4670 FULTON ST E STE 201, ADA, MI 493018409 (Tel: 6165912905)

πŸ“
Updated Business Mailing Address September 15, 2025

Registered at 4670 FULTON ST E STE 201, ADA, MI 493018409

πŸ‘€
Provider Name / Credentials Updated September 15, 2025

Recorded as KELLI VAN DER HEIDE

βœ…
NPI Profile Active October 21, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) October 21, 2014

Registered at 7086 8TH AVE, JENISON, MI 494289352 (Tel: 6166679551)

πŸ“
Business Mailing Address (Initial Record) October 21, 2014

Registered at 1430 JENNINGS ST SE, GRAND RAPIDS, MI 495073721

πŸ‘€
Provider Name / Credentials (Initial Record) October 21, 2014

Recorded as KELLI VAN WYK

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) October 21, 2014

Speech-Language Pathologist (license number reported to NPPES: MI 7101004541)

🟒
Initial NPI Registration & Enumeration October 21, 2014

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1134523020
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 21, 2014
Last Update: September 15, 2025
Sole Proprietor: No

Mailing Address

4670 Fulton St E Ste 201

Ada, MI 493018409

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.