{"npi":"1134523020","type":"NPI-1","status":"active","name":{"display":"Kelli Van Der Heide","other":[{"code":"1","type":"Formerly known as","value":"VAN WYK, KELLI"}],"first":"KELLI","last":"VAN DER HEIDE"},"specialty":{"primary_taxonomy":"235Z00000X","primary_taxonomy_description":"Speech-Language Pathology","slug":"speech-language-pathology","schema_org_specialty":"Speech","all":[{"code":"235Z00000X","description":"Speech-Language Pathology","primary":true,"state":"MI","license":"7101004541"}]},"addresses":[{"purpose":"LOCATION","street_1":"4670 FULTON ST E STE 201","city":"ADA","state":"MI","postal_code":"493018409","country_code":"US","phone":"6165912905"},{"purpose":"MAILING","street_1":"4670 FULTON ST E STE 201","city":"ADA","state":"MI","postal_code":"493018409","country_code":"US"}],"license":{"state":"MI","number":"7101004541"},"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20141208002186","type_code":"14-15","type_desc":"PRACTITIONER - QUALIFIED SPEECH LANGUAGE PATHOLOGIST","state":"MI","pac_id":"4789906462"}]},"enumeration_date":"2014-10-21","last_updated":"2025-09-15","_meta":{"source":"NPPES","snapshot_date":"2025-09-15","doc_url":"https://findmynpi.com/api"}}