Individual provider Active NPI

Shulunda Kinta' Gibson, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Bellaire, TX
National Provider Identifier
1053596551
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
100744 Issued in TX
Practice address
6575 West Loop S Ste 500
Bellaire, TX 77401-3509
Phone
(713) 560-2369
Fax
(281) 754-4290
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2022

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 100744 TX Primary

Addresses

Primary practice location

6575 West Loop S Ste 500
Bellaire, TX 77401-3509

Mailing address

6575 West Loop S Ste 500
Bellaire, TX 77401-3509
Phone (713) 560-2369

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101130001091 TX Practitioner - Qualified Speech Language Pathologist 5799971990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6575 W Loop S
Suite 500
Bellaire, TX 77401-3509
Phone (713) 560-2369

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Speech & Voice Care Center of Houston, PLLC Speech-Language Pathologist CurrentSince Dec 1, 2018 Accepting new patients

Locations

6575 West Loop S
Ste 500
Bellaire, TX 77401
Phone (713) 560-2369

4660 Beechnut St
Ste 220
Houston, TX 77096
Phone (469) 387-0219

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1053596551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6575 WEST LOOP S STE 500",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013509",
            "telephone_number": "713-560-2369",
            "fax_number": "281-754-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6575 WEST LOOP S STE 500",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013509",
            "telephone_number": "713-560-2369",
            "fax_number": "281-754-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SHULUNDA",
        "middle_name": "KINTA'",
        "name_prefix": "Ms.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "100744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellaire, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; 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.