Active NPI
Shannon Rielly
- Speech-Language Pathologist
- Jupiter, FL
National Provider Identifier
1144656786
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SZ6392
- Practice address
- 128 East Bay Cedar Cir.
Jupiter, FL 33458 - Phone
- (561) 670-4864
- NPI assigned
- Sep 15, 2013
- 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 | SZ6392 | FL | Primary |
Addresses
Primary practice location
128 East Bay Cedar Cir.
Jupiter, FL 33458
Mailing address
4081 Chestnut Ave
Palm Beach Gardens, FL 33410-2145
Phone (561) 601-2624
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 |
|---|---|---|---|
| SZ6392 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380844800000",
"number": "1144656786",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4081 CHESTNUT AVE",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334102145",
"telephone_number": "561-601-2624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "128 EAST BAY CEDAR CIR.",
"city": "JUPITER",
"state": "FL",
"postal_code": "33458",
"telephone_number": "561-670-4864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIELLY",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-15",
"last_updated": "2013-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SZ6392",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jupiter, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.