Individual provider Active NPI

Lisa Amussen Reese

  • Speech-Language Pathologist
  • Elko, NV
National Provider Identifier
1285058362
Registry record updated Feb 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP-1666 Issued in NV
Practice address
2850 Ruby Vista Dr
Elko, NV 89801-1615
Phone
(775) 753-5500
NPI assigned
Feb 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2014

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 SP-1666 NV Primary

Addresses

Primary practice location

2850 Ruby Vista Dr
Elko, NV 89801-1615

Mailing address

2780 Jennings Way
Elko, NV 89801-4715
Phone (385) 290-9382

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
SP-1666NVMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391990400000",
    "number": "1285058362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 JENNINGS WAY",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898014715",
            "telephone_number": "385-290-9382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 RUBY VISTA DR",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898011615",
            "telephone_number": "775-753-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REESE",
        "first_name": "LISA",
        "middle_name": "AMUSSEN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NV",
            "license": "SP-1666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elko, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.

Verify at the official NPI Registry.