Individual provider Active NPI

Lisa B. Hansen, SPEECH PATHOLOGIST

  • Speech-Language Pathologist
  • Sebastian, FL
National Provider Identifier
1861719775
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA4571 Issued in FL
Practice address
1670 Barber St
Sebastian, FL 32958-6243
Phone
(772) 226-5454
NPI assigned
May 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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 SA4571 FL Primary

Addresses

Primary practice location

1670 Barber St
Sebastian, FL 32958-6243

Mailing address

1670 Barber St
Sebastian, FL 32958-6243
Phone (772) 226-5454

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
SA4571FLMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1272758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1861719775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 BARBER ST",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586243",
            "telephone_number": "772-226-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 BARBER ST",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329586243",
            "telephone_number": "772-226-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "LISA",
        "middle_name": "B.",
        "credential": "SPEECH PATHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-02",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; 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.