Active NPI
Lisa A. Grant, M.S., CCC-SLP
- Speech-Language Pathologist
- Blue Springs, MO
National Provider Identifier
1437200524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 109652
- Practice address
- 1111 SE Eastridge Dr
Blue Springs, MO 64014-3440 - Phone
- (816) 213-6173
- Fax
- (816) 229-6997
- NPI assigned
- Jan 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 109652 | MO | Primary |
Addresses
Primary practice location
1111 SE Eastridge Dr
Blue Springs, MO 64014-3440
Mailing address
1111 SE Eastridge Dr
Blue Springs, MO 64014-3440
Phone (816) 213-6173
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
| License | State | Type | Specialty |
|---|---|---|---|
| 109652 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1437200524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 SE EASTRIDGE DR",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640143440",
"telephone_number": "816-213-6173",
"fax_number": "816-229-6997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 SE EASTRIDGE DR",
"city": "BLUE SPRINGS",
"state": "MO",
"postal_code": "640143440",
"telephone_number": "816-213-6173",
"fax_number": "816-229-6997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "LISA",
"middle_name": "A.",
"name_prefix": "Mrs.",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "109652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Springs, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.