Individual provider Active NPI

Lisa Bisson, M.S.

  • Speech-Language Pathologist
  • Reynoldsburg, OH
National Provider Identifier
1326450370
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.11641 Issued in OH
Practice address
8579 Summit Rd
Reynoldsburg, OH 43068-1411
Phone
(716) 640-6713
NPI assigned
May 27, 2014
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X COND.2014164-SP OH
Speech-Language Pathologist 235Z00000X SP.11641 OH Primary

Addresses

Primary practice location

8579 Summit Rd
Reynoldsburg, OH 43068-1411

Mailing address

1522 Marvin Dr
Reynoldsburg, OH 43068-2930
Phone (716) 640-6713

Other practice location 1

8044 Tributary Ln
Reynoldsburg, OH 43068-9591
Phone (716) 640-6713

Other identifiers 1

IdentifierTypeStateIssuer
0239789MedicaidOH

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
COND.2014164-SPOHMDSpeech-Language Pathologist
SP.11641OHMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1401148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1326450370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1522 MARVIN DR",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430682930",
            "telephone_number": "716-640-6713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8579 SUMMIT RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681411",
            "telephone_number": "716-640-6713"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8044 Tributary Ln",
            "address_purpose": "LOCATION",
            "city": "Reynoldsburg",
            "state": "OH",
            "postal_code": "430689591",
            "country_code": "US",
            "telephone_number": "716-640-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BISSON",
        "first_name": "LISA",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-27",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "COND.2014164-SP",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.11641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0239789",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.