Active NPI
Lara Lynn Goldie, MS CCC-SLP
- Speech-Language Pathologist
- Salt Lake City, UT
National Provider Identifier
1992086649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7542382-4104
- Practice address
- 100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103 - Phone
- (801) 662-4980
- Fax
- (801) 662-4964
- NPI assigned
- Sep 7, 2011
- 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 | 7542382-4104 | UT | Primary |
Addresses
Primary practice location
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Mailing address
100 Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 662-4980
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7542382-4104 | UT | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1992086649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-4980",
"fax_number": "801-662-4964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MARIO CAPECCHI DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841131103",
"telephone_number": "801-662-4980",
"fax_number": "801-662-4964"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDIE",
"first_name": "LARA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "UT",
"license": "7542382-4104",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salt Lake City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.