Individual provider Active NPI

Lisa Waters Anderson, SLP

  • Speech-Language Pathologist
  • Des Moines, IA
National Provider Identifier
1285928309
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
01512 Issued in IA
Practice address
1525 Beaver Ave
Des Moines, IA 50310-4426
Phone
(515) 255-9298
NPI assigned
Jun 6, 2011
Last updated
Jun 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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 01512 IA Primary

Addresses

Primary practice location

1525 Beaver Ave
Des Moines, IA 50310-4426

Mailing address

1525 Beaver Ave
Des Moines, IA 50310-4426
Phone (515) 255-9298

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220215001371 IA Practitioner - Qualified Speech Language Pathologist 6800289844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Ear CenterGroup PAC ID 2264582493, 11 clinicians

Practice addresses (Care Compare)

12499 University Ave
Suite 200
Clive, IA 50325-8288
Phone (515) 418-9960

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01512IAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Ear Center CurrentSince Feb 1, 2022 Accepting new patients
Iowa Ear Technology PastSince Feb 1, 2022 Accepting new patients

Locations

12499 University Ave
Ste 200
Clive, IA 50325
Phone (515) 418-9960

Organizations & group practices 2

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": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307318400000",
    "number": "1285928309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104426",
            "telephone_number": "515-255-9298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 BEAVER AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503104426",
            "telephone_number": "515-255-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "LISA",
        "middle_name": "WATERS",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "01512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.