Individual provider Active NPI

Lisa Huschke

  • Speech-Language Pathologist
  • Forest, VA
National Provider Identifier
1265664536
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202004256 Issued in VA
Practice address
305 Gristmill Dr
Forest, VA 24551-2627
Phone
(434) 385-1074
Fax
(434) 385-1342
NPI assigned
Aug 19, 2009
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 2202004256 VA Primary

Addresses

Primary practice location

305 Gristmill Dr
Forest, VA 24551-2627

Mailing address

1135 Lejack Cir
Forest, VA 24551-1273

Other practice location 1

1135 Lejack Cir
Forest, VA 24551-1273
Phone (434) 249-4123

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
2202004256VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Pediatric Therapies, Inc. Speech-Language Pathologist PastSince Aug 30, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1265664536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 LEJACK CIR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245511273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 GRISTMILL DR",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512627",
            "telephone_number": "434-385-1074",
            "fax_number": "434-385-1342"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 Lejack Cir",
            "address_purpose": "LOCATION",
            "city": "Forest",
            "state": "VA",
            "postal_code": "245511273",
            "country_code": "US",
            "telephone_number": "434-249-4123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUSCHKE",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-19",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.