Individual provider Active NPI

Dana D Shea, CCC-SLP

  • Speech-Language Pathologist
  • Commerce Township, MI
National Provider Identifier
1235316209
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12031900 Issued in CA
Practice address
2075 E West Maple Rd
Suite B204
Commerce Township, MI 48390-3816
Phone
(248) 926-0909
Fax
(248) 624-3332
NPI assigned
Jan 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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 12031900 CA Primary

Addresses

Primary practice location

2075 E West Maple Rd
Suite B204
Commerce Township, MI 48390-3816

Mailing address

2075 E West Maple Rd
Suite B204
Commerce Township, MI 48390-3816
Phone (248) 926-0909

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

LicenseStateTypeSpecialty
12031900CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Detroit Institute for Children Past Accepting new patients
Detroit Institute for Children Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222300800000",
    "number": "1235316209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 E WEST MAPLE RD",
            "address_2": "SUITE B204",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903816",
            "telephone_number": "248-926-0909",
            "fax_number": "248-624-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 E WEST MAPLE RD",
            "address_2": "SUITE B204",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903816",
            "telephone_number": "248-926-0909",
            "fax_number": "248-624-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "DANA",
        "middle_name": "D",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-22",
        "last_updated": "2008-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "12031900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.