Active NPI
Lois Vanderbilt, CCC-SLP
- Speech-Language Pathologist
- Anchorage, AK
National Provider Identifier
1164634846
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 133
- Practice address
- 3330 Arctic Blvd. Ste. 101
Anchorage, AK 99503 - Phone
- (907) 550-3040
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 133 | AK | Primary |
Addresses
Primary practice location
3330 Arctic Blvd. Ste. 101
Anchorage, AK 99503
Mailing address
6549 Colgate Dr
Anchorage, AK 99504-3308
Phone (907) 748-5374
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
| License | State | Type | Specialty |
|---|---|---|---|
| 133 | AK | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1326153600000",
"number": "1164634846",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6549 COLGATE DR",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995043308",
"telephone_number": "907-748-5374",
"fax_number": "907-346-5437"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3330 ARCTIC BLVD. STE. 101",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "99503",
"telephone_number": "907-550-3040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERBILT",
"first_name": "LOIS",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2012-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AK",
"license": "133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.