Active NPI 1316072903 Individual Practitioner Female Practitioner

Lisa Jean Wise , MA CCC SLP

Speech-Language Pathologist • Vandalia, MO

Professional Overview & Biography Verified Profile Summary

Lisa Wise, MA CCC SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Vandalia, MO. Practice services are available at 2200 W HIGHWAY 54 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2200 W Highway 54
Van-Far R-1 School District

Vandalia, MO 633821130

Telephone 5735946111

Fax 5735942878

Associated Practice Facility / Clinic

🏢 Van Far R-I Facility NPI 1538281126

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Vandalia, MO

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 13.4 Yrs

Regional Practice Density

3 Specialists

Practicing in Vandalia, MO (5112 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License MO 2002013175

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

467477907 (MO)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active September 21, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location September 21, 2007

Registered at 2200 W HIGHWAY 54, VAN-FAR R-1 SCHOOL DISTRICT, VANDALIA, MO 633821130 (Tel: 5735946111)

📍

Updated Business Mailing Address September 21, 2007

Registered at 4398 HIGHWAY W, VANDALIA, MO 633824408 (Tel: 5737215568)

👤

Provider Name / Credentials Updated September 21, 2007

Recorded as LISA WISE, MA CCC SLP

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 21, 2007

Speech-Language Pathologist (License #2002013175 in MO)

🟢

Initial NPI Registration & Enumeration February 22, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1316072903

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 22, 2007

Last Update: September 21, 2007

Sole Proprietor: No

Update or Correct Profile

Mailing Address

4398 Highway W

Vandalia, MO 633824408

Phone: 5737215568

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.