Individual provider Active NPI

Lisa Coil

  • Speech-Language Pathologist
  • Fort Wayne, IN
National Provider Identifier
1720311368
Registry record updated Sep 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004289A Issued in IN
Practice address
808 Mill Lake Rd
Fort Wayne, IN 46845-6400
Phone
(260) 338-1241
Fax
(260) 338-1231
NPI assigned
Sep 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2009

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 22004289A IN Primary

Addresses

Primary practice location

808 Mill Lake Rd
Fort Wayne, IN 46845-6400

Mailing address

808 Mill Lake Rd
Fort Wayne, IN 46845-6400
Phone (260) 338-1241

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

LicenseStateTypeSpecialty
22004289AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Possibilities Northeast, LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1252972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1720311368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COIL",
        "first_name": "LISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-15",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004289A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.