Individual provider Active NPI

Lauren Fardig

  • Speech-Language Pathologist
  • Somerset, MA
National Provider Identifier
1104366541
Registry record updated Mar 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8865 Issued in MA
Practice address
106 Betsy B Ave
Somerset, MA 02725-2125
Phone
(774) 644-1301
NPI assigned
Mar 5, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2017

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 8865 MA Primary

Addresses

Primary practice location

106 Betsy B Ave
Somerset, MA 02725-2125

Mailing address

106 Betsy B Ave
Somerset, MA 02725-2125
Phone (774) 644-1301

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

State licenses

LicenseStateTypeSpecialty
8865MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1488672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488672000000",
    "number": "1104366541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 BETSY B AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027252125",
            "telephone_number": "774-644-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 BETSY B AVE",
            "city": "SOMERSET",
            "state": "MA",
            "postal_code": "027252125",
            "telephone_number": "774-644-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARDIG",
        "first_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-05",
        "last_updated": "2017-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "8865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2017; 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.