Shannon Lee Gundersen

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP15368 Issued in AZ

Practice address

3941 E Baseline Rd Ste 101
Gilbert, AZ 85234-2750

Phone

(480) 787-5387

NPI assigned

May 31, 2019

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

Other names 1

• Shannon Lee Schaefer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Baio Enterprises

  • Speech-Language Pathologist
  • Mesa, AZ
  • NPI 1477801686
  NPD (past)
• Baio Enterprises Inc

  • Developmental Disabilities Clinic/Center
  • Mesa, AZ
  • NPI 1457421604
  NPD (past)

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1013575307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 E LEXINGTON AVE",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852340400",
            "telephone_number": "724-328-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3941 E BASELINE RD STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342750",
            "telephone_number": "480-787-5387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "SHANNON",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP15368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SCHAEFER",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reve Guillaume-Partee
• Imani Guillory
• Matthew Gulbrandsen, MD
• Anelisse Guler, SLP-A
• Josette Gullickson
• Taylor M Gunderson
• Cary L Gundlach, DC
• Cheyenne Gunsalus, RN
• Sunita Gupta, MD
• Tare C Gurira, D.C.

• Speech-Language Pathologist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; 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.