Active NPI
Anna Matsuda Ladisch, M.A. CCC-SLP
- Speech-Language Pathologist
- West Lafayette, IN
National Provider Identifier
1245470459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22004643A
- Practice address
- 3295 Mendel Dr
West Lafayette, IN 47906-5177 - Phone
- (561) 252-9909
- Fax
- (480) 287-8021
- NPI assigned
- Feb 27, 2009
- 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 | 22004643A | IN | Primary |
Addresses
Primary practice location
3295 Mendel Dr
West Lafayette, IN 47906-5177
Mailing address
3295 Mendel Dr
West Lafayette, IN 47906-5177
Phone (561) 252-9909
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22004643A | Other | IN | INDIANA STATE BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY |
| 12907686 | Other | MD | ASHA CERTIFICATION |
Other names 1
- Miss Anna Matsuda
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22004643A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235692800000",
"number": "1245470459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3295 MENDEL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479065177",
"telephone_number": "561-252-9909",
"fax_number": "480-287-8021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3295 MENDEL DR",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479065177",
"telephone_number": "561-252-9909",
"fax_number": "480-287-8021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LADISCH",
"first_name": "ANNA",
"middle_name": "MATSUDA",
"name_prefix": "Mrs.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-27",
"last_updated": "2009-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22004643A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIANA STATE BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY",
"identifier": "22004643A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATION",
"identifier": "12907686",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANNA",
"last_name": "MATSUDA",
"prefix": "MISS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in West Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.