Lisa Knierim Ivanov, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202006805 Issued in VA

Practice address

8575 Rixlew LN
Manassas, VA 20109-3701

Phone

(703) 257-2941

NPI assigned

Nov 15, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

Enrollment records 2

Specialty

Qualified Speech Language Pathologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Roanoke, VA
  • NPI 1740820828

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• RWW Senior Living Outpatient Rehab Services, LLC

  • Physical Therapist
  • Henrico, VA
  • NPI 1669292512

  DC

  Medicare reassignment NPD
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Cary, NC
  • NPI 1225879489

  Speech-Language Pathologist

  NPD
• RWW Senior Living Outpatient Rehab Services, LLC

  • Physical Therapist
  • Sarasota, FL
  • NPI 1619833803
  NPD

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363824000000",
    "number": "1972847192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24476 RIPPLE CT",
            "city": "ALDIE",
            "state": "VA",
            "postal_code": "201055503",
            "telephone_number": "904-703-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 RIXLEW LN",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201093701",
            "telephone_number": "703-257-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVANOV",
        "first_name": "LISA",
        "middle_name": "KNIERIM",
        "name_prefix": "Mrs.",
        "credential": "CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2013-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janelle Tatiana Irizarry, APRN, AGNP
• Sharla Irons
• Gilbert Raymond Irwin, M.D.P.C.
• Ismile of Manassas PLLC
• Salihah Israel
• Amitis Izadi Lowery
• Adaku Lilian Izunwanne
• J Nelson MD PC
• Akira Jackson, CSW
• Keira Michelle Jackson

• Speech-Language Pathologist in Manassas, VA
• Providers in Manassas, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.