Individual provider Active NPI

Lorena Ilisapesi Rivera, SLP-ASSISTANT

  • Speech-Language Assistant
  • Euless, TX
National Provider Identifier
1598473399
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
42832 Issued in TX
Practice address
12816 Chittamwood TRL
Euless, TX 76040-7129
Phone
(817) 269-5413
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X 42832 TX Primary

Addresses

Primary practice location

12816 Chittamwood TRL
Euless, TX 76040-7129

Mailing address

12816 Chittamwood TRL
Euless, TX 76040-7129
Phone (817) 269-5413

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

LicenseStateTypeSpecialty
42832TXMDSpeech-Language Assistant

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668038400000",
    "number": "1598473399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12816 CHITTAMWOOD TRL",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760407129",
            "telephone_number": "817-269-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12816 CHITTAMWOOD TRL",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760407129",
            "telephone_number": "817-269-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVERA",
        "first_name": "LORENA",
        "middle_name": "ILISAPESI",
        "credential": "SLP-ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "42832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euless, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; 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.