Shanyn Leak

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

808 Mill Lake Rd
Fort Wayne, IN 46845-6400

Phone

(260) 338-1241

Fax

(260) 338-1231

NPI assigned

Jun 26, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Possibilities Northeast, LLC

  • Multi-Specialty Clinic/Center
  • Fort Wayne, IN
  • NPI 1063616340
  NPD (past)

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

{
    "created_epoch": "1214438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1154583557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MILL LAKE RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468456400",
            "telephone_number": "260-338-1241",
            "fax_number": "260-338-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEAK",
        "first_name": "SHANYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-26",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jocelyn Layne
• Shelby Layne, LMHCA
• Thomas L Lazoff, M.D.
• League for the Blind and Disabled, Inc
• Nathaniel S Leahy, PA-C
• Ana Sofia Leal Bramasco, M.D.
• Leap of Faith Enterprises, Inc.
• Mallory Leatherman 062519
• Kristina R Leavell, PA-C
• Catherine A Leber, PA-C

• Speech-Language Pathologist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.