Individual provider Active NPI

Linda Lacher-Goddard, MACCCSLP

  • Speech-Language Pathologist
  • Eagan, MN
National Provider Identifier
1861532848
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6077 Issued in MN
Practice address
2795 Pilot Knob Rd
Suite 100
Eagan, MN 55121-1119
Phone
(651) 994-9644
Fax
(651) 994-8962
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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 6077 MN Primary

Addresses

Primary practice location

2795 Pilot Knob Rd
Suite 100
Eagan, MN 55121-1119

Mailing address

2795 Pilot Knob Rd Ste 100
Eagan, MN 55121-1930
Phone (651) 994-9644

Other identifiers 4

IdentifierTypeStateIssuer
4600211OtherMNMEDICA
964S4LAOtherMNBCBS
514148600MedicaidMN
HP32580OtherMNHEALTH PARTNERS

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1861532848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD STE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211930",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2795 PILOT KNOB RD",
            "address_2": "SUITE 100",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551211119",
            "telephone_number": "651-994-9644",
            "fax_number": "651-994-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACHER-GODDARD",
        "first_name": "LINDA",
        "credential": "MACCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "6077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4600211",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "964S4LA",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "514148600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP32580",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.