Individual provider Active NPI

Lisanne Simms Craven, M.S.

  • Speech-Language Pathologist
  • Louisville, KY
National Provider Identifier
1699901637
Registry record updated Aug 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0405 Issued in KY
Practice address
9931 Forest Green Blvd
Louisville, KY 40223-5123
Phone
(502) 588-0750
NPI assigned
Jun 4, 2009
Last updated
Aug 24, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2020

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 0405 KY Primary

Addresses

Primary practice location

9931 Forest Green Blvd
Louisville, KY 40223-5123

Mailing address

2028 Strathmoor Blvd
Louisville, KY 40205-2528
Phone (502) 893-1285

Other identifiers 1

IdentifierTypeStateIssuer
7100321590MedicaidKY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120525000563 KY Practitioner - Qualified Speech Language Pathologist 5698938884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

401 E Chestnut St
Suite 710
Louisville, KY 40202-5707
Phone 50258383032

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0405KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. Speech-Language Pathologist CurrentSince Mar 13, 2017 Accepting new patients
Lisanne S. Craven and Associates, PLLC Speech-Language Pathologist Past Accepting new patients
Merit Anesthesia PLLC PastSince Apr 1, 2020 Accepting new patients
VA Medical Center Speech-Language Pathologist Past Accepting new patients

Locations

401 E Chestnut St
Unit 710
Louisville, KY 40202
Phone 50258383031332

9931 Forest Green Blvd
Louisville, KY 40223
Phone (502) 588-0750

Organizations & group practices 5

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": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1699901637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 STRATHMOOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052528",
            "telephone_number": "502-893-1285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9931 FOREST GREEN BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235123",
            "telephone_number": "502-588-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAVEN",
        "first_name": "LISANNE",
        "middle_name": "SIMMS",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "0405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100321590",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.