Shannon Hagan, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10815 Issued in NC

Practice address

1101 Hartwell St
Garner, NC 27529-3675

Phone

(919) 772-8888

NPI assigned

Apr 9, 2014

Last updated

Jun 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1235558032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 HARTWELL ST",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 HARTWELL ST",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275293675",
            "telephone_number": "919-772-8888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11030 Raven Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276148511",
            "country_code": "US",
            "telephone_number": "919-844-6611",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGAN",
        "first_name": "SHANNON",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "10815",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Grigsby
• Stephanie M Grimaldi, PHARMD
• Michael James Guerrero, ATC
• Andrew Richard Haberkorn, PHARMD
• Nicholas Anthony Hadgis, DPT
• Anita Lynette Hagans, LCSWA
• Julia Hageman
• Ryan Hahner, ATC, LAT
• Halikierra Community Servcies LLC
• Claudia Hall

• Speech-Language Pathologist in Garner, NC
• Providers in Garner, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.