Organization Active NPI

Shaping Speech, LLC

  • Speech-Language Pathologist
  • Oviedo, FL
National Provider Identifier
1194959403
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA 9884 Issued in FL
Legal business name
SHAPING SPEECH, LLC
Practice address
1358 Twin Rivers Blvd
Oviedo, FL 32766-5082
Phone
(407) 690-2056
NPI assigned
May 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Authorized official

Name
Kelly Robertson, M.A. CCC-SLP
Title
Managing Member
Phone
(407) 690-2056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language PathologistGroup: 193400000X SINGLE SPECIALTY GROUP 235Z00000X SA 9884 FL Primary

Addresses

Primary practice location

1358 Twin Rivers Blvd
Oviedo, FL 32766-5082

Mailing address

PO Box 621454
Oviedo, FL 32762-1454
Phone (407) 690-2056

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1242259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1194959403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 621454",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327621454",
            "telephone_number": "407-690-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1358 TWIN RIVERS BLVD",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327665082",
            "telephone_number": "407-690-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAPING SPEECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-14",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "407-690-2056",
        "authorized_official_credential": "M.A. CCC-SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 9884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oviedo, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.