Active NPI
Lisa Page
- Speech-Language Pathologist
- Texarkana, AR
National Provider Identifier
1700925633
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP-1005
- Practice address
- 6419 Shetland Way
Texarkana, AR 71854-8827 - Phone
- (870) 779-0634
- NPI assigned
- Feb 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | SP-1005 | AR | Primary |
Addresses
Primary practice location
6419 Shetland Way
Texarkana, AR 71854-8827
Mailing address
6419 Shetland Way
Texarkana, AR 71854-8827
Phone (870) 779-0634
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 |
|---|---|---|---|
| SP-1005 | AR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1700925633",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6419 SHETLAND WAY",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718548827",
"telephone_number": "870-779-0634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6419 SHETLAND WAY",
"city": "TEXARKANA",
"state": "AR",
"postal_code": "718548827",
"telephone_number": "870-779-0634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "LISA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AR",
"license": "SP-1005",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Texarkana, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.