Individual provider Active NPI

Lisa Borja

  • Speech-Language Pathologist
  • Las Vegas, NV
National Provider Identifier
1245505486
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
828 Issued in NV
Practice address
3501 Shady Timber St
Apt 1056
Las Vegas, NV 89129-7586
Phone
(702) 868-7691
NPI assigned
Mar 21, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 828 NV Primary

Addresses

Primary practice location

3501 Shady Timber St
Apt 1056
Las Vegas, NV 89129-7586

Mailing address

3501 Shady Timber St
Apt 1056
Las Vegas, NV 89129-7586

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

LicenseStateTypeSpecialty
828NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1245505486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 SHADY TIMBER ST",
            "address_2": "APT 1056",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 SHADY TIMBER ST",
            "address_2": "APT 1056",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891297586",
            "telephone_number": "702-868-7691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORJA",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.

Verify at the official NPI Registry.