Active NPI
Shelley D Paulson, MS CCC
- Speech-Language Pathologist
- Las Vegas, NV
National Provider Identifier
1316014517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP-91
- Practice address
- 5516 S Fort Apache Rd Ste 130
Las Vegas, NV 89148-7679 - Phone
- (702) 641-8255
- Fax
- (702) 399-8255
- NPI assigned
- Nov 30, 2006
- Sex
- Female
- Sole proprietor
- No
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 Pathologist | 235Z00000X | SP-91 | NV | Primary |
Addresses
Primary practice location
5516 S Fort Apache Rd Ste 130
Las Vegas, NV 89148-7679
Mailing address
1811 Rainbow Blvd Suite 210
Las Vegas, NV 89146
Phone (702) 641-8255
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)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP-91 | NV | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583107200000",
"number": "1316014517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1811 RAINBOW BLVD SUITE 210",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89146",
"telephone_number": "702-641-8255",
"fax_number": "702-399-8255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5516 S FORT APACHE RD STE 130",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891487679",
"telephone_number": "702-641-8255",
"fax_number": "702-399-8255"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "SHELLEY",
"middle_name": "D",
"name_prefix": "Mrs.",
"credential": "MS CCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-30",
"last_updated": "2020-03-02",
"certification_date": "2020-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NV",
"license": "SP-91",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.