Alexandra Shaw

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6304 Issued in SC

Practice address

3851 Commercial Center Dr
Ladson, SC 29456-4146

Phone

(843) 314-5434

NPI assigned

Sep 11, 2014

Last updated

Feb 22, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Tri-County Therapy, LLC

  • Speech-Language Pathologist
  • Ladson, SC
  • NPI 1447591607
  NPD (past)

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

{
    "created_epoch": "1410393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1144621954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 COMMERCIAL CENTER DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564146",
            "telephone_number": "843-314-5434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3851 COMMERCIAL CENTER DR",
            "city": "LADSON",
            "state": "SC",
            "postal_code": "294564146",
            "telephone_number": "843-314-5434"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 Vonderburg Dr",
            "address_2": "Suite 201",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335115900",
            "country_code": "US",
            "telephone_number": "813-653-1149",
            "fax_number": "813-654-6644",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "29 N Academy St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296012629",
            "country_code": "US",
            "telephone_number": "864-331-1400",
            "fax_number": "864-331-1416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAW",
        "first_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-11",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ6855",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "6304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA1822",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013320400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Sepic
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• Amy Seymour, PT
• Alexandra Shade
• Kelli E Shapiro, MS
• Mia Shillingsford, OTR/L
• Shout Eat Play
• Loren Simms
• Simply Strong Physical Therapy LLC
• Carolyn Simpson

• Speech-Language Pathologist in Ladson, SC
• Providers in Ladson, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.

Verify at the official NPI Registry.