Active NPI
Shannon Burchett Schieder, M.A. CCC-SLP
- Speech-Language Pathologist
- Holly Springs, NC
National Provider Identifier
1104954411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 5085
- Practice address
- 360 Raleigh Street
Holly Springs, NC 27540 - Phone
- (919) 342-5754
- Fax
- (919) 552-0861
- NPI assigned
- Feb 28, 2007
- 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 | 5085 | NC | Primary |
Addresses
Primary practice location
360 Raleigh Street
Holly Springs, NC 27540
Mailing address
120 Flint Point LN
Holly Springs, NC 27540-6813
Phone (919) 567-8224
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7411600 | Medicaid | NC | |
| 126AY | Other | NC | BLUE CROSS BLUE SHIELD |
| 018CV | Other | NC | BLUE CROSS BLUE SHIELD |
| 7212036 | Medicaid | NC |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5085 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Speech Therapy Center of Holly Springs, P.C. | Speech-Language Pathologist | Past | Accepting new patients |
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.
-
- Speech-Language Pathologist
- Holly Springs, NC
- NPI 1104978816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1104954411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 FLINT POINT LN",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "275406813",
"telephone_number": "919-567-8224",
"fax_number": "919-552-0861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 RALEIGH STREET",
"city": "HOLLY SPRINGS",
"state": "NC",
"postal_code": "27540",
"telephone_number": "919-342-5754",
"fax_number": "919-552-0861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHIEDER",
"first_name": "SHANNON",
"middle_name": "BURCHETT",
"name_prefix": "Mrs.",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "5085",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7411600",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "126AY",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "018CV",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7212036",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Holly Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.