NPIMap

Organization Active NPI

VA Medical Center

  • Speech-Language Pathologist
  • Louisville, KY
National Provider Identifier
1730234055
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
405 Issued in KY
Legal business name
VA MEDICAL CENTER
Practice address
2028 Strathmoor Blvd
Louisville, KY 40205-2528
Phone
(502) 459-8052
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Lisanne Simms Craven, M.S., CCCNPI 1699901637
Title
Speech-Language Pathologist
Phone
(502) 459-8052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X 405 KY Primary

Addresses

Primary practice location

2028 Strathmoor Blvd
Louisville, KY 40205-2528

Mailing address

2028 Strathmoor Blvd
Louisville, KY 40205-2528
Phone (502) 459-8052

National Provider Directory

National Provider Directory
Tax ID family
Louisville Vamc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730234055",
    "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": "502-459-8052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 STRATHMOOR BLVD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402052528",
            "telephone_number": "502-459-8052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CRAVEN",
        "authorized_official_first_name": "LISANNE",
        "authorized_official_middle_name": "SIMMS",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "502-459-8052",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CCC"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "405",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 22, 2020; 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.