Shannon A Davis, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 9236 Issued in FL

Practice address

140 Pennock Landing Cir
Jupiter, FL 33458-4020

Phone

(561) 951-2947

NPI assigned

Nov 28, 2006

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

Other identifiers 1

Other names 1

• Shannon Peekstok Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1366519316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 PENNOCK LANDING CIR",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584020",
            "telephone_number": "561-951-2947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 PENNOCK LANDING CIR",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584020",
            "telephone_number": "561-951-2947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "SHANNON",
        "middle_name": "A",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SZ 4037",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 9236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8916497 00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "PEEKSTOK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janice S Davidson, MS, OTR/L
• Kathleen L Davis, NP
• Lois-Anne Ward Davis, CCC-SLP
• Patricia Davis, OTR/L,CHT
• Randy Davis
• Timothy Davis, PA-C
• Betsy De Boer, LCSW
• Johan De la Cruz
• De Lima Counseling Group, LLC
• Anna Lisa De Lima, PH.D, LMHC, NCC, QS

• Speech-Language Pathologist in Jupiter, FL
• Providers in Jupiter, 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 Jun 9, 2010; 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.