Individual provider Active NPI

Cynthia Anne Shotliff, MS, CCC-SLP

  • Speech-Language Pathologist
  • Little Silver, NJ
National Provider Identifier
1073255717
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
41YS00408700 Issued in NJ
Practice address
17 Crest Dr
Little Silver, NJ 07739-1317
Phone
(732) 910-4074
NPI assigned
Apr 12, 2022
Last updated
Apr 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 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 41YS00408700 NJ Primary

Addresses

Primary practice location

17 Crest Dr
Little Silver, NJ 07739-1317

Mailing address

124 Cheyenne St
Tinton Falls, NJ 07712-7752
Phone (908) 433-5644

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

LicenseStateTypeSpecialty
41YS00408700NJMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Breakthrough Pediatric Speech Therapy LLC Speech-Language Pathologist CurrentSince Jan 14, 2024 Accepting new patients

Locations

1806 State Route 35
Ste 207
Oakhurst, NJ 07755
Phone (732) 800-4941

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1073255717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 CHEYENNE ST",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077127752",
            "telephone_number": "908-433-5644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 CREST DR",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391317",
            "telephone_number": "732-910-4074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTLIFF",
        "first_name": "CYNTHIA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00408700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.