Active NPI
Lisa Goolsby Lee, MED, CCC-SLP
- Speech-Language Pathologist
- Macon, GA
National Provider Identifier
1679907497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP006324
- Practice address
- 4149 Arkwright Rd
Suite D
Macon, GA 31210-1732 - Phone
- (478) 731-3677
- Fax
- (478) 405-0363
- NPI assigned
- Aug 28, 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 | SLP006324 | GA | Primary |
Addresses
Primary practice location
4149 Arkwright Rd
Suite D
Macon, GA 31210-1732
Mailing address
402 Arden LN N
Macon, GA 31210-7605
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP006324 | GA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middle Georgia Pediatrics | 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 and National Provider Directory roles.
-
- Early Intervention Provider Agency
- Macon, GA
- NPI 1982865408
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377648000000",
"number": "1679907497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 ARDEN LN N",
"city": "MACON",
"state": "GA",
"postal_code": "312107605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4149 ARKWRIGHT RD",
"address_2": "SUITE D",
"city": "MACON",
"state": "GA",
"postal_code": "312101732",
"telephone_number": "478-731-3677",
"fax_number": "478-405-0363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "LISA",
"middle_name": "GOOLSBY",
"credential": "MED, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-28",
"last_updated": "2013-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "SLP006324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.