Active NPI
Lisa Madison, MA CCC/SLP
- Speech-Language Pathologist
- Portland, ME
National Provider Identifier
1700047479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP1475
- Practice address
- 196 Allen Ave
Portland, ME 04103-3711 - Phone
- (207) 874-8133
- NPI assigned
- Jun 24, 2008
- 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 | SP1475 | ME | Primary |
Addresses
Primary practice location
196 Allen Ave
Portland, ME 04103-3711
Mailing address
196 Allen Ave
Portland, ME 04103-3711
Phone (207) 874-8133
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP1475 | ME | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288137600000",
"number": "1700047479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 ALLEN AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041033711",
"telephone_number": "207-874-8133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 ALLEN AVE",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041033711",
"telephone_number": "207-874-8133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADISON",
"first_name": "LISA",
"credential": "MA CCC/SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-24",
"last_updated": "2010-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "ME",
"license": "SP1475",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.