Active NPI
Christy Renee Shivers
- Speech-Language Assistant
- Queen Creek, AZ
National Provider Identifier
1215518451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA12985
- Practice address
- 21985 E Rosa Rd
Queen Creek, AZ 85142-4587 - Phone
- (480) 226-5832
- NPI assigned
- Apr 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | SLPA12985 | AZ | Primary |
Addresses
Primary practice location
21985 E Rosa Rd
Queen Creek, AZ 85142-4587
Mailing address
21985 E Rosa Rd
Queen Creek, AZ 85142-4587
Phone (480) 226-5832
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SLPA12985 | Other | AZ | SLPA LICENSE |
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 |
|---|---|---|---|
| SLPA12985 | AZ | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618790400000",
"number": "1215518451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21985 E ROSA RD",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851424587",
"telephone_number": "480-226-5832"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21985 E ROSA RD",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "851424587",
"telephone_number": "480-226-5832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVERS",
"first_name": "CHRISTY",
"middle_name": "RENEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-19",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA12985",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SLPA LICENSE",
"identifier": "SLPA12985",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queen Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 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.