Individual provider Active NPI

Marissa Sherman, SLP

  • Speech-Language Pathologist
  • Hollywood, FL
National Provider Identifier
1235595471
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA14654 Issued in FL
Practice address
11011 Sheridan St
Suite 209
Hollywood, FL 33026-1505
Phone
(954) 431-5467
Fax
(954) 431-0202
NPI assigned
Jan 4, 2016
Last updated
Jun 30, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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 SA14654 FL Primary

Addresses

Primary practice location

11011 Sheridan St
Suite 209
Hollywood, FL 33026-1505

Mailing address

11011 Sheridan St
Suite 209
Hollywood, FL 33026-1505
Phone (954) 431-5437

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
SA14654FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pieces of Inspiration Inc Speech-Language Pathologist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1451865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498780800000",
    "number": "1235595471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST",
            "address_2": "SUITE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261505",
            "telephone_number": "954-431-5437",
            "fax_number": "954-432-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11011 SHERIDAN ST",
            "address_2": "SUITE 209",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330261505",
            "telephone_number": "954-431-5467",
            "fax_number": "954-431-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "MARISSA",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-04",
        "last_updated": "2017-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA14654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hollywood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.