Individual provider Active NPI

Elizabeth Lewis

  • Speech-Language Pathologist
  • Grand Island, NE
National Provider Identifier
1104291061
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2510 Issued in NE
Practice address
3004 W Faidley Ave
Grand Island, NE 68803-4109
Phone
(308) 398-5170
NPI assigned
Dec 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2510 NE Primary

Addresses

Primary practice location

3004 W Faidley Ave
Grand Island, NE 68803-4109

Mailing address

PO Box 5285
Grand Island, NE 68802-5285
Phone (308) 675-1853

Other practice location 1

3601 Cimarron Plz Ste 105
Hastings, NE 68901-2883
Phone (402) 463-2077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200323001618 NE Practitioner - Qualified Speech Language Pathologist 1658709852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Go Physical Therapy LLCGroup PAC ID 0749258994, 98 clinicians

Practice addresses (Care Compare)

3004 W Faidley Ave
Grand Island, NE 68803-4109
Phone (308) 398-5170

Merit-based Incentive Payment System (MIPS)

Final score
85.76 of 100Reported as group
Quality
89.57
Improvement activities
40
Cost
71.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2510NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Go Physical Therapy, LLC CurrentSince Jan 1, 2020 Accepting new patients

Locations

905 N Custer Ave
Grand Island, NE 68803
Phone (308) 398-2170

3004 W Faidley Ave
Grand Island, NE 68803
Phone (308) 382-0344

620 N Diers Ave
Ste 300
Grand Island, NE 68803
Phone (308) 382-0344

3601 Cimarron Plz
Ste 105
Hastings, NE 68901
Phone (402) 463-2077

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1104291061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5285",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688025285",
            "telephone_number": "308-675-1853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 W FAIDLEY AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034109",
            "telephone_number": "308-398-5170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 Cimarron Plz Ste 105",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689012883",
            "country_code": "US",
            "telephone_number": "402-463-2077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-03",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "2510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.