Active NPI
Lisa C Nelson
- Speech-Language Pathologist
- Richmond, VA
National Provider Identifier
1780762740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202002515
- Practice address
- 3600 Saunders Ave.
Richmond, VA 23227-4347 - Phone
- (804) 358-1874
- Fax
- (804) 278-8977
- NPI assigned
- Nov 1, 2006
- 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 | 2202002515 | VA | Primary |
Addresses
Primary practice location
3600 Saunders Ave.
Richmond, VA 23227-4347
Mailing address
3600 Saunders Ave.
Richmond, VA 23227-4347
Phone (804) 358-1874
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 280488 | Other | VA | OPTIMUM CHOICE |
| 31752 | Medicaid | VA | |
| 4978013 | Medicaid | VA | |
| 7756200 | Other | VI | AETNA |
| 40463 | Medicaid | VI | |
| ANTHEM | Other | VA | ANTHEM |
| 004978013 | Medicaid | VA | |
| UNITED HEALTHCARE | Other | VA | UNITED HEALTHCARE |
| 961110 | Other | VA | SOUTHERN HEALTH |
| 192086 | Medicaid | VA |
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 |
|---|---|---|---|
| 2202002515 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1780762740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3600 SAUNDERS AVE.",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232274347",
"telephone_number": "804-358-1874",
"fax_number": "804-278-8977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3600 SAUNDERS AVE.",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232274347",
"telephone_number": "804-358-1874",
"fax_number": "804-278-8977"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "LISA",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202002515",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMUM CHOICE",
"identifier": "280488",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "31752",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4978013",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7756200",
"state": "VI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40463",
"state": "VI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "ANTHEM",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004978013",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "UNITED HEALTHCARE",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SOUTHERN HEALTH",
"identifier": "961110",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "192086",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.