Individual provider Active NPI

Shannon Renee Barton, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Woodland, CA
National Provider Identifier
1174765028
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP 13878 Issued in CA
Practice address
96 W Main St
Suite B
Woodland, CA 95695-3016
Phone
(530) 668-1010
Fax
(530) 668-9799
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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 SP 13878 CA Primary

Addresses

Primary practice location

96 W Main St
Suite B
Woodland, CA 95695-3016

Mailing address

210 Maedell Way
Woodland, CA 95695-4623
Phone (530) 662-6324

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SP 13878CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1174765028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 MAEDELL WAY",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956954623",
            "telephone_number": "530-662-6324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 W MAIN ST",
            "address_2": "SUITE B",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "956953016",
            "telephone_number": "530-668-1010",
            "fax_number": "530-668-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTON",
        "first_name": "SHANNON",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP 13878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.