Rebecca Shultz, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22007194A Issued in IN

Practice address

227 S Main St Ste 100
South Bend, IN 46601-2124

Phone

(847) 284-4294

Fax

(574) 544-5977

NPI assigned

Feb 9, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Michiana Speech Lab LLC

  • Speech-Language Pathologist
  • South Bend, IN
  • NPI 1942038526
  NPD

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1083478002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 S MAIN ST STE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012124",
            "telephone_number": "847-284-4294",
            "fax_number": "574-544-5977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S MAIN ST STE 100",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012124",
            "telephone_number": "847-284-4294",
            "fax_number": "574-544-5977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 S Michigan St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466014000",
            "country_code": "US",
            "telephone_number": "847-284-4294",
            "fax_number": "574-544-5977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHULTZ",
        "first_name": "REBECCA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-06-29",
        "certification_date": "2024-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22007194A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James L Short, O.D.
• Amy K Shoue, PT
• Emily Marie Shoupe, PHARMD
• Lillian Shroyer, LCSW
• Jon Andrew Shull, M.D.
• Robert Milford Shuman, M.D.
• Cierra Sibilla, BCBA
• Warren William Sibilla Jr., PH.D.
• James Paul Sieradzki, M.D.
• Nancy Betsaida Sigala Flores

• Speech-Language Pathologist in South Bend, IN
• Providers in South Bend, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.