Active NPI
Shelby Paige Diviney, SLP
- Speech-Language Pathologist
- Fort Worth, TX
National Provider Identifier
1114218484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 24924
- Practice address
- 1400 8TH Ave
Fort Worth, TX 76104-4110 - Phone
- (817) 922-7105
- NPI assigned
- Apr 21, 2011
- 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 | 24924 | TX | Primary |
Addresses
Primary practice location
1400 8TH Ave
Fort Worth, TX 76104-4110
Mailing address
3800 Pelham Rd
Fort Worth, TX 76116-7376
Phone (817) 932-0506
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24924 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303344000000",
"number": "1114218484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3800 PELHAM RD",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761167376",
"telephone_number": "817-932-0506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761044110",
"telephone_number": "817-922-7105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIVINEY",
"first_name": "SHELBY",
"middle_name": "PAIGE",
"name_prefix": "Mrs.",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-21",
"last_updated": "2011-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "24924",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.