Individual provider Active NPI

Shana Stanley, SLP

  • Speech-Language Pathologist
  • Norton, VA
National Provider Identifier
1386307338
Registry record updated Oct 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202005769 Issued in VA
Practice address
1490 Park Ave NW
Norton, VA 24273-1631
Phone
(276) 439-1450
NPI assigned
Oct 18, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2021

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 2202005769 VA Primary

Addresses

Primary practice location

1490 Park Ave NW
Norton, VA 24273-1631

Mailing address

304 Chestnut St NW
Norton, VA 24273-1402
Phone (276) 870-7511

Other practice location 1

157 Ross Carter Blvd
Duffield, VA 24244-5116
Phone (276) 431-2841

Other identifiers 1

IdentifierTypeStateIssuer
DSLLS619OtherVALONG TERM CARE

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
2202005769VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1386307338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 CHESTNUT ST NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731402",
            "telephone_number": "276-870-7511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 PARK AVE NW",
            "city": "NORTON",
            "state": "VA",
            "postal_code": "242731631",
            "telephone_number": "276-439-1450"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "157 Ross Carter Blvd",
            "address_purpose": "LOCATION",
            "city": "Duffield",
            "state": "VA",
            "postal_code": "242445116",
            "country_code": "US",
            "telephone_number": "276-431-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "SHANA",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-18",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LONG TERM CARE",
            "identifier": "DSLLS619",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.