Individual provider Active NPI

Hidi K Shoemaker, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Wabash, IN
National Provider Identifier
1114147493
Registry record updated Apr 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22004023A Issued in IN
Practice address
5270 W Millcreek Pike
Wabash, IN 46992-9256
Phone
(765) 667-1115
NPI assigned
Apr 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2017

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 22004023A IN Primary

Addresses

Primary practice location

5270 W Millcreek Pike
Wabash, IN 46992-9256

Mailing address

5270 W Millcreek Pike
Wabash, IN 46992-9256
Phone (765) 667-1115

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
22004023AINMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jul 8, 2023 Accepting new patients
Creative Health Care Management LLC Speech-Language Pathologist CurrentSince Jul 8, 2023 Accepting new patients

Locations

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

10 S 9th St
Ste 4
Noblesville, IN 46060

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492560000000",
    "number": "1114147493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5270 W MILLCREEK PIKE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469929256",
            "telephone_number": "765-667-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5270 W MILLCREEK PIKE",
            "city": "WABASH",
            "state": "IN",
            "postal_code": "469929256",
            "telephone_number": "765-667-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOEMAKER",
        "first_name": "HIDI",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-27",
        "last_updated": "2017-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22004023A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wabash, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.