Individual provider Active NPI

Shore Fleury

  • Speech-Language Pathologist
  • Baton Rouge, LA
National Provider Identifier
1073369583
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
9414 Issued in LA
Practice address
760 Maxine Dr
Baton Rouge, LA 70808-5930
Phone
(225) 929-8600
NPI assigned
Apr 25, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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 9414 LA Primary

Addresses

Primary practice location

760 Maxine Dr
Baton Rouge, LA 70808-5930

Mailing address

6870 Manchac Rd
Saint Gabriel, LA 70776-5425

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

State licenses

LicenseStateTypeSpecialty
9414LAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1073369583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6870 MANCHAC RD",
            "city": "SAINT GABRIEL",
            "state": "LA",
            "postal_code": "707765425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MAXINE DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708085930",
            "telephone_number": "225-929-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEURY",
        "first_name": "SHORE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "9414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.