Individual provider Active NPI

Lakita R Tomlin, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Florissant, MO
National Provider Identifier
1497746291
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2005026624 Issued in MO
Practice address
100 Saint Francois St Ste 107
Florissant, MO 63031-5131
Phone
(314) 252-8363
NPI assigned
Oct 31, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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 2005026624 MO Primary

Addresses

Primary practice location

100 Saint Francois St Ste 107
Florissant, MO 63031-5131

Mailing address

100 Saint Francois St Ste 107
Florissant, MO 63031-5131
Phone (314) 252-8363

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
2005026624MOMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Progressive Rehab Solutions CurrentSince Aug 1, 2011 Accepting new patients
Progressive Rehab Solutions LLC CurrentSince Aug 1, 2011 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1497746291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SAINT FRANCOIS ST STE 107",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315131",
            "telephone_number": "314-252-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SAINT FRANCOIS ST STE 107",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630315131",
            "telephone_number": "314-252-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMLIN",
        "first_name": "LAKITA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2005026624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florissant, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2021; 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.