Active NPI
Lisa J Killam, SLP
- Speech-Language Pathologist
- Natick, MA
National Provider Identifier
1629316849
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP4540SL
- Practice address
- 10 W Central St
Natick, MA 01760-4537 - Phone
- (617) 817-4005
- NPI assigned
- Jan 23, 2013
- Last updated
- Jan 23, 2013
- 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 | SP4540SL | MA | Primary |
Addresses
Primary practice location
10 W Central St
Natick, MA 01760-4537
Mailing address
13 Marshall Rd
Natick, MA 01760-2922
Phone (508) 650-0748
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 |
|---|---|---|---|
| SP4540SL | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Time 2Talk | 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": "1358899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1358899200000",
"number": "1629316849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 MARSHALL RD",
"city": "NATICK",
"state": "MA",
"postal_code": "017602922",
"telephone_number": "508-650-0748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 W CENTRAL ST",
"city": "NATICK",
"state": "MA",
"postal_code": "017604537",
"telephone_number": "617-817-4005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KILLAM",
"first_name": "LISA",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-23",
"last_updated": "2013-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "SP4540SL",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Natick, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.