Active NPI
Shelbie Burditt
- Speech-Language Assistant
- Riverside, CA
National Provider Identifier
1407230683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SPA 2653
- Practice address
- 990 Central Ave
Riverside, CA 92507-0224 - Phone
- (951) 500-4698
- NPI assigned
- Jul 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | SPA 2653 | CA | Primary |
Addresses
Primary practice location
990 Central Ave
Riverside, CA 92507-0224
Mailing address
990 Central Ave
Riverside, CA 92507-0224
Phone (951) 500-4698
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
| License | State | Type | Specialty |
|---|---|---|---|
| SPA 2653 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437004800000",
"number": "1407230683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "990 CENTRAL AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070224",
"telephone_number": "951-500-4698"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "990 CENTRAL AVE",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925070224",
"telephone_number": "951-500-4698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURDITT",
"first_name": "SHELBIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-16",
"last_updated": "2015-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "CA",
"license": "SPA 2653",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.