Active NPI
Susan Tassie Lynch, SLP
- Speech-Language Pathologist
- Springfield, MO
National Provider Identifier
1740331313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 01869
- Practice address
- 5406 S Kimbrough Ave
Springfield, MO 65810-2727 - Phone
- (417) 882-3414
- NPI assigned
- Jan 12, 2007
- 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 | 01869 | MO | Primary |
Addresses
Primary practice location
5406 S Kimbrough Ave
Springfield, MO 65810-2727
Mailing address
940 N Jefferson Ave
Springfield, MO 65802-3718
Phone (417) 523-0000
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 |
|---|---|---|---|
| 01869 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1740331313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 N JEFFERSON AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658023718",
"telephone_number": "417-523-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5406 S KIMBROUGH AVE",
"city": "SPRINGFIELD",
"state": "MO",
"postal_code": "658102727",
"telephone_number": "417-882-3414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYNCH",
"first_name": "SUSAN",
"middle_name": "TASSIE",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "01869",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.