Active NPI
Shannon Leigh Lockhart, SLP
- Speech-Language Pathologist
- North Port, FL
National Provider Identifier
1194301663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18230
- Practice address
- 6929 Outreach Way
North Port, FL 34287-3493 - Phone
- (941) 371-8820
- NPI assigned
- Mar 23, 2021
- 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 | 18230 | FL | Primary |
Addresses
Primary practice location
6929 Outreach Way
North Port, FL 34287-3493
Mailing address
4944 Bella Terra Dr
Venice, FL 34293-6074
Phone (915) 539-6127
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12145201 | Other | ASHA CERTIFICATE OF CLINICAL COMPETENCE | |
| 18230 | Other | FL | STATE OF FLORIDA DEPARTMENT OF HEALTH |
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 |
|---|---|---|---|
| 18230 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616457600000",
"number": "1194301663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4944 BELLA TERRA DR",
"city": "VENICE",
"state": "FL",
"postal_code": "342936074",
"telephone_number": "915-539-6127"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6929 OUTREACH WAY",
"city": "NORTH PORT",
"state": "FL",
"postal_code": "342873493",
"telephone_number": "941-371-8820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKHART",
"first_name": "SHANNON",
"middle_name": "LEIGH",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-23",
"last_updated": "2021-03-23",
"certification_date": "2021-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "18230",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATE OF CLINICAL COMPETENCE",
"identifier": "12145201",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF FLORIDA DEPARTMENT OF HEALTH",
"identifier": "18230",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in North Port, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.