Dianne Lacey Lewis, M.C.D., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP003612 Issued in GA

Practice address

27 Shoal Creek FLS
Signal Mountain, TN 37377-3141

Phone

(423) 468-4096

NPI assigned

Apr 18, 2007

Last updated

Feb 24, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361664000000",
    "number": "1003032798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SHOAL CREEK FLS",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373773141",
            "telephone_number": "423-468-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SHOAL CREEK FLS",
            "city": "SIGNAL MOUNTAIN",
            "state": "TN",
            "postal_code": "373773141",
            "telephone_number": "423-468-4096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DIANNE",
        "middle_name": "LACEY",
        "name_prefix": "Mrs.",
        "credential": "M.C.D., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP003612",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP0000004940",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000693316B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000693316C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane O Jones, MD
• Chrissy Elaine Knowles, PTA
• Mindy N Lane, LMSW
• Peggy Stottlemyer Larochelle, PT
• Katherine Leister, BCBA
• Mary Ann Light, APN
• Leah Marie Linn, MA
• Sue Wright Martin, PTA
• Joshua Paul Masters
• Elicia Baker Matthews, PT

• Speech-Language Pathologist in Signal Mountain, TN
• Providers in Signal Mountain, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2013; 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.