Active NPI
Lisa Maria Reynolds, M.S., CCC-SLP
- Speech-Language Pathologist
- Midlothian, TX
National Provider Identifier
1023768827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 17842
- Practice address
- 100 Walter Stephenson Rd
Midlothian, TX 76065-3699 - Phone
- (469) 644-9810
- NPI assigned
- Mar 24, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 17842 | TX | Primary |
Addresses
Primary practice location
100 Walter Stephenson Rd
Midlothian, TX 76065-3699
Mailing address
100 Walter Stephenson Rd
Midlothian, TX 76065-3699
Phone (469) 644-9810
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 14568671 | Other | TX | TX DRIVERS LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17842 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1023768827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 WALTER STEPHENSON RD",
"city": "MIDLOTHIAN",
"state": "TX",
"postal_code": "760653699",
"telephone_number": "469-644-9810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 WALTER STEPHENSON RD",
"city": "MIDLOTHIAN",
"state": "TX",
"postal_code": "760653699",
"telephone_number": "469-644-9810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "LISA",
"middle_name": "MARIA",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-24",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "17842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TX DRIVERS LICENSE",
"identifier": "14568671",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Midlothian, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.