Shannon L Nelson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA6198 Issued in FL

Practice address

1441 Metropolis Avenue
Ft. Myers, FL 33912

Phone

(239) 561-2778

NPI assigned

Jan 4, 2010

Last updated

Apr 16, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shannon Lyn Peckham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1346570983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 FAIRWAY DR",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233209402",
            "telephone_number": "239-233-1354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 METROPOLIS AVENUE",
            "city": "FT. MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-561-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202012368",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6198",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "PECKHAM",
            "middle_name": "LYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ericka Blaufuss Nelson, ARNP
• Forrest Nelson
• Gretchen Nelson, ARNP
• Jasen Nelson
• Kayla Nelson, SLP-CCC
• Tegan Leigh Nelson, PT
• Tracy Zaneta Nelson, OWNER
• Alicia C Nemeth, RN
• Kira Isabel Nemeth
• Jason Nemitz, MD

• Speech-Language Pathologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2026; 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.