Lisa M Thompson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5975 Issued in MN

Practice address

2105 Hennepin Avenue North
Glencoe, MN 55336

Phone

(320) 864-7790

NPI assigned

Aug 29, 2018

Last updated

Aug 29, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1535500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1316429160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8451 KIMBALL DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553472135",
            "telephone_number": "612-214-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 HENNEPIN AVENUE NORTH",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "55336",
            "telephone_number": "320-864-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-29",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "5975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Glencoe, MN
• Providers in Glencoe, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; 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.