NPIMap

Organization Active NPI

Premier Speech Therapy, LLC

  • Speech-Language Pathologist
  • Londonderry, NH
National Provider Identifier
1679719132
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
PREMIER SPEECH THERAPY, LLC
Practice address
80 Nashua Rd, BLDG B, Unit 4
Londonderry, NH 03053-3426
Phone
(603) 818-4448
Fax
(603) 818-8704
NPI assigned
Jan 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Authorized official

Name
Lisa M Minahan, MS, CCC-SLPNPI 1750491718
Title
Speech-Langage Pathologist
Phone
(603) 818-4448

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

80 Nashua Rd, BLDG B, Unit 4
Londonderry, NH 03053-3426

Mailing address

80 Nashua Rd, BLDG B, Unit 4
Londonderry, NH 03053-3426
Phone (603) 818-4448

Other identifiers 1

IdentifierTypeStateIssuer
30407232MedicaidNH

Other names 1

  • Premier Speech Therapy Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130403000003 NH Part B Supplier - Clinic/Group Practice 1759526346 Receives reassigned benefits from 2 practitioners
Practice locations: Londonderry, NH

National Provider Directory

National Provider Directory

Locations

114 Londonderry Tpke
Ste 3
Hooksett, NH 03106
Phone (603) 548-2188

80 Nashua Rd
Ste B4
Londonderry, NH 03053
Phone (603) 548-2188

80 Nashua Rd
Ste 4
Londonderry, NH 03053
Phone (603) 548-2188

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1561507200000",
    "number": "1679719132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 NASHUA RD, BLDG B, UNIT 4",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533426",
            "telephone_number": "603-818-4448",
            "fax_number": "603-818-8704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 NASHUA RD, BLDG B, UNIT 4",
            "city": "LONDONDERRY",
            "state": "NH",
            "postal_code": "030533426",
            "telephone_number": "603-818-4448",
            "fax_number": "603-818-8704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SPEECH THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-05",
        "last_updated": "2019-06-26",
        "status": "A",
        "authorized_official_last_name": "MINAHAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SPEECH-LANGAGE PATHOLOGIST",
        "authorized_official_telephone_number": "603-818-4448",
        "authorized_official_credential": "MS, CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30407232",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Speech Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Premier Speech Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Londonderry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.