Individual provider Active NPI

Lisa B. Grace, SLP

  • Speech-Language Pathologist
  • Fredericksburg, VA
National Provider Identifier
1619424272
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202002820 Issued in VA
Practice address
20 Carriage Hill Lane
Fredericksburg, VA 22407
Phone
(540) 429-6323
Fax
(540) 786-0625
NPI assigned
Sep 1, 2016
Last updated
Oct 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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 2202002820 VA Primary

Addresses

Primary practice location

20 Carriage Hill Lane
Fredericksburg, VA 22407

Mailing address

20 Carriage Hill Lane
Fredericksburg, VA 22407
Phone (540) 429-6323

Other names 1

  • Mrs. Lisa B. Tibbetts-Osso Former name

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
2202002820VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wee Talk Speech-Language Services Speech-Language Pathologist Past Accepting new patients

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": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727913600000",
    "number": "1619424272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CARRIAGE HILL LANE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-429-6323",
            "fax_number": "540-786-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CARRIAGE HILL LANE",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "22407",
            "telephone_number": "540-429-6323",
            "fax_number": "540-786-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "LISA",
        "middle_name": "B.",
        "name_prefix": "Ms.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2024-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202002820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "TIBBETTS-OSSO",
            "middle_name": "B.",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.