Individual provider Active NPI

Shelley Robinson Oliver, MS/CCC-SLP

  • Speech-Language Pathologist
  • Penfield, NY
National Provider Identifier
1417233875
Registry record updated Oct 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
005609 Issued in NY
Practice address
1994 Five Mile Line Rd
Penfield, NY 14526-1054
Phone
(315) 524-1000
Fax
(315) 524-1169
NPI assigned
Oct 31, 2011
Last updated
Oct 31, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2011

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 005609 NY Primary

Addresses

Primary practice location

1994 Five Mile Line Rd
Penfield, NY 14526-1054

Mailing address

1994 Five Mile Line Rd
Penfield, NY 14526-1054
Phone (315) 524-1000

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
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1320019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1417233875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1994 FIVE MILE LINE RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261054",
            "telephone_number": "315-524-1000",
            "fax_number": "315-524-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1994 FIVE MILE LINE RD",
            "city": "PENFIELD",
            "state": "NY",
            "postal_code": "145261054",
            "telephone_number": "315-524-1000",
            "fax_number": "315-524-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "SHELLEY",
        "middle_name": "ROBINSON",
        "name_prefix": "Ms.",
        "credential": "MS/CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-31",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "005609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Penfield, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.