Active NPI
Lacy Lynn Vannorsdel
- Speech-Language Pathologist
- Fort Collins, CO
National Provider Identifier
1225447048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 101314
- Practice address
- 2133 Krisron Rd
Unit A101
Fort Collins, CO 80525-6756 - Phone
- (605) 660-2111
- NPI assigned
- Aug 6, 2014
- 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 | 101314 | CO | Primary |
Addresses
Primary practice location
2133 Krisron Rd
Unit A101
Fort Collins, CO 80525-6756
Mailing address
2133 Krisron Rd
Unit A101
Fort Collins, CO 80525-6756
Phone (605) 660-2111
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 |
|---|---|---|---|
| 101314 | CO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407283200000",
"number": "1225447048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2133 KRISRON RD",
"address_2": "UNIT A101",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805256756",
"telephone_number": "605-660-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2133 KRISRON RD",
"address_2": "UNIT A101",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805256756",
"telephone_number": "605-660-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANNORSDEL",
"first_name": "LACY",
"middle_name": "LYNN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-06",
"last_updated": "2014-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CO",
"license": "101314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.