Organization Active NPI

Lifespan Therapy PLLC

  • Speech-Language Pathologist
  • Fletcher, NC
National Provider Identifier
1013679950
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LIFESPAN THERAPY PLLC
Practice address
4020 Hendersonville Rd Ste E
Fletcher, NC 28732-8251
Phone
(828) 222-4875
NPI assigned
Oct 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Authorized official

Name
Alicia Kae WhiteNPI 1902383730
Title
Speech-Language Pathologist/Owner
Phone
(282) 224-8758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

4020 Hendersonville Rd Ste E
Fletcher, NC 28732-8251

Mailing address

4020 Hendersonville Rd Ste E
Fletcher, NC 28732-8251
Phone (828) 222-4875

Other identifiers 1

IdentifierTypeStateIssuer
1902383730OtherNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211118000804 NC Part B Supplier - Clinic/Group Practice 4587053244 Receives reassigned benefits from 4 practitioners
Practice locations: Fletcher, NC

National Provider Directory

National Provider Directory

Locations

4020 Hendersonville Rd
Ste E
Fletcher, NC 28732
Phone (828) 222-4875

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691625600000",
    "number": "1013679950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 HENDERSONVILLE RD STE E",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287328251",
            "telephone_number": "828-222-4875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 HENDERSONVILLE RD STE E",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287328251",
            "telephone_number": "828-222-4875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ALICIA",
        "authorized_official_middle_name": "KAE",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST/OWNER",
        "authorized_official_telephone_number": "282-224-8758"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1902383730",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fletcher, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; 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.