Active NPI
Lisa Knudsen, M.S.,SLP
- Speech-Language Pathologist
- Providence, RI
National Provider Identifier
1184875148
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 53064
- Practice address
- 1000 Eddy Street
Providence, RI 02905 - Phone
- (401) 533-9100
- NPI assigned
- Oct 8, 2008
- 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 | 53064 | RI | Primary |
Addresses
Primary practice location
1000 Eddy Street
Providence, RI 02905
Mailing address
1000 Eddy Street
Providence, RI 02905
Phone (401) 533-9100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4600103 | Other | RI | MEETING STREET |
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 |
|---|---|---|---|
| 53064 | RI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223424000000",
"number": "1184875148",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 EDDY STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02905",
"telephone_number": "401-533-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 EDDY STREET",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02905",
"telephone_number": "401-533-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUDSEN",
"first_name": "LISA",
"credential": "M.S.,SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-08",
"last_updated": "2008-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "RI",
"license": "53064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEETING STREET",
"identifier": "4600103",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.