Individual provider Active NPI

Megan Sarah Luttrell, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Knoxville, TN
National Provider Identifier
1417140278
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3517 Issued in TN
Practice address
9040 Executive Park Dr Ste 105
Knoxville, TN 37923-4630
Phone
(865) 693-5622
Fax
(865) 769-0801
NPI assigned
Aug 23, 2007
Last updated
Dec 4, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 3517 TN Primary

Addresses

Primary practice location

9040 Executive Park Dr Ste 105
Knoxville, TN 37923-4630

Mailing address

9040 Executive Park Dr Ste 105
Knoxville, TN 37923-4630
Phone (865) 293-6237

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)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3517TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Aspirus Keweenaw Current Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1000 Cedar St
Houghton, MI 49931
Phone (906) 482-8201

205 Osceola St
Laurium, MI 49913
Phone (906) 337-3100

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1417140278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 EXECUTIVE PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234630",
            "telephone_number": "865-293-6237",
            "fax_number": "865-769-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 EXECUTIVE PARK DR STE 105",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234630",
            "telephone_number": "865-693-5622",
            "fax_number": "865-769-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTTRELL",
        "first_name": "MEGAN",
        "middle_name": "SARAH",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.