Lisa Lynne Petrass, M.A. ED. C.C.C.-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22002846A Issued in IN

Practice address

9811 Saratoga Rd
Fort Wayne, IN 46804-7039

Phone

(260) 602-2924

Fax

(260) 432-1109

NPI assigned

Apr 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1177113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245458827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9811 SARATOGA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047039",
            "telephone_number": "260-602-2924",
            "fax_number": "260-432-1109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9811 SARATOGA RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468047039",
            "telephone_number": "260-602-2924",
            "fax_number": "260-432-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRASS",
        "first_name": "LISA",
        "middle_name": "LYNNE",
        "credential": "M.A. ED. C.C.C.-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002846A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Peterson, NP
• Patricia Gail Peterson, RN
• Shalesta Bright Peterson, BA
• Susan K. Peterson, PA
• Monnett Petilos, LPT
• Chandra Leigh Petro, NP
• Julie Pettibone
• Robert Pettibone, BCBA
• William C Petty, M.D.
• Elizabeth A Pfeiffer, M.D.

• Speech-Language Pathologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.