Active NPI
Shelby Lynne Holsapple
- Speech-Language Pathologist
- Mulberry, IN
National Provider Identifier
1093304495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22007385A
- Practice address
- 502 W Jackson St
Mulberry, IN 46058-9538 - Phone
- (765) 296-2911
- NPI assigned
- Jan 11, 2021
- Last updated
- Jan 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 22007385A | IN | Primary |
Addresses
Primary practice location
502 W Jackson St
Mulberry, IN 46058-9538
Mailing address
3136 Bowfield Way
West Lafayette, IN 47906-6812
Phone (309) 265-2874
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22007385A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610323200000",
"number": "1093304495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3136 BOWFIELD WAY",
"city": "WEST LAFAYETTE",
"state": "IN",
"postal_code": "479066812",
"telephone_number": "309-265-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "502 W JACKSON ST",
"city": "MULBERRY",
"state": "IN",
"postal_code": "460589538",
"telephone_number": "765-296-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLSAPPLE",
"first_name": "SHELBY",
"middle_name": "LYNNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-11",
"last_updated": "2021-01-11",
"certification_date": "2021-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22007385A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mulberry, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.