Individual provider Active NPI

Shirah Lynn Hoffman, M.S.CCC-SLP

  • Speech-Language Pathologist
  • Fort Myers, FL
National Provider Identifier
1114067311
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 8875 Issued in FL
Practice address
6430 Plantation Park CT Ste 200
Fort Myers, FL 33966-4816
Phone
(239) 215-1025
Fax
(239) 985-9386
NPI assigned
Feb 7, 2007
Last updated
Nov 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 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 SA 8875 FL Primary

Addresses

Primary practice location

6430 Plantation Park CT Ste 200
Fort Myers, FL 33966-4816

Mailing address

4310 Metro Pkwy Ste 205
Fort Myers, FL 33916-9416
Phone (239) 236-8784

Other practice location 1

4550 Colonial Blvd
Fort Myers, FL 33912-1017
Phone (239) 931-5700 ext. 5700

Other names 1

  • Shirah Lynn Bengston Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231031003438 FL Practitioner - Qualified Speech Language Pathologist 8820444540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SA 8875FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Dna Comprehensive Therapy Services, LLC Speech-Language Pathologist CurrentSince Sep 19, 2023 Accepting new patients
Bonita Springs Retirement Village, Inc. CurrentSince Sep 19, 2023 Accepting new patients

Locations

4310 Metro Pkwy
Ste 205
Fort Myers, FL 33916

6430 Plantation Park Ct
Ste 200
Fort Myers, FL 33966
Phone (239) 215-1025

100 E Sybelia Ave
Ste 150
Maitland, FL 32751
Phone (407) 765-5437

3191 Harbor Blvd
Ste A
Pt Charlotte, FL 33952
Phone (941) 766-9555

5825 Argerian Dr
Ste 101
Wesley Chapel, FL 33545
Phone (813) 687-4870

Organizations & group practices 2

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1114067311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 METRO PKWY STE 205",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169416",
            "telephone_number": "239-236-8784",
            "fax_number": "239-790-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6430 PLANTATION PARK CT STE 200",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664816",
            "telephone_number": "239-215-1025",
            "fax_number": "239-985-9386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4550 Colonial Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339121017",
            "country_code": "US",
            "telephone_number": "239-931-5700 x5700",
            "fax_number": "239-931-5738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFFMAN",
        "first_name": "SHIRAH",
        "middle_name": "LYNN",
        "credential": "M.S.CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 8875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRAH",
            "last_name": "BENGSTON",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.