Individual provider Active NPI

Allyssa Sarah Jean Larose, MS CF-SLP

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1710493424
Registry record updated Dec 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
600 Issued in NE
Practice address
6901 Burt St
Omaha, NE 68132-2643
Phone
(402) 557-4300
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2017

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 600 NE Primary

Addresses

Primary practice location

6901 Burt St
Omaha, NE 68132-2643

Mailing address

4312 Chicago St
Omaha, NE 68131-2217
Phone (402) 830-0415

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105002640 NE Practitioner - Qualified Speech Language Pathologist 9537412770 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
600NEMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Father Flanagan's Boys' Home CurrentSince Sep 22, 2018 Accepting new patients
ENT Services PC Speech-Language Pathologist Past Accepting new patients
Father Flanagan's Boys Home Past Accepting new patients

Locations

14080 Boys Town Hospital Rd
Boys Town, NE 68010
Phone (402) 778-6900

425 N 30th St
Omaha, NE 68131
Phone (402) 452-5000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1710493424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4312 CHICAGO ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681312217",
            "telephone_number": "402-830-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 BURT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681322643",
            "telephone_number": "402-557-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROSE",
        "first_name": "ALLYSSA",
        "middle_name": "SARAH JEAN",
        "credential": "MS CF-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; 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.