Active NPI
Larisa G Wing
- Speech-Language Assistant
- China, ME
National Provider Identifier
1528396165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SAS1763
- Practice address
- 18 Riga Road
China, ME 04358 - Phone
- (207) 557-2545
- NPI assigned
- Nov 19, 2009
- Last updated
- Apr 24, 2020
- 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 Assistant | 2355S0801X | SAS1763 | ME | Primary |
Addresses
Primary practice location
18 Riga Road
China, ME 04358
Mailing address
33 Kennedy Memorial Dr
Waterville, ME 04901-5128
Phone (207) 626-3497
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SAS1763 | ME | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587686400000",
"number": "1528396165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 KENNEDY MEMORIAL DR",
"city": "WATERVILLE",
"state": "ME",
"postal_code": "049015128",
"telephone_number": "207-626-3497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 RIGA ROAD",
"city": "CHINA",
"state": "ME",
"postal_code": "04358",
"telephone_number": "207-557-2545"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WING",
"first_name": "LARISA",
"middle_name": "G",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-19",
"last_updated": "2020-04-24",
"certification_date": "2020-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "ME",
"license": "SAS1763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in China, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.