Individual provider Active NPI

Shawn D Christensen, CCC-SLP

  • Speech-Language Pathologist
  • Tempe, AZ
National Provider Identifier
1457605362
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP8048 Issued in AZ
Practice address
1930 E Southern Ave
Tempe, AZ 85282-7518
Phone
(480) 456-0719
Fax
(480) 456-0163
NPI assigned
Oct 30, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2018

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 SLP8048 AZ Primary

Addresses

Primary practice location

1930 E Southern Ave
Tempe, AZ 85282-7518

Mailing address

1930 E Southern Ave
Tempe, AZ 85282-7518
Phone (480) 456-0719

Other identifiers 1

IdentifierTypeStateIssuer
751587MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240226002846 UT Practitioner - Qualified Speech Language Pathologist 2567727639 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc CurrentSince Jan 13, 2024 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services, Inc. CurrentSince Jan 13, 2024 Accepting new patients
Pioneer Pet, LLC PastSince Jan 22, 2018 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

201 W Layton Pkwy
Layton, UT 84041
Phone (801) 543-6000

280 N Main St
N Salt Lake, UT 84010
Phone (801) 270-4400

527 W 400 N
Orem, UT 84057
Phone (801) 221-0281

3741 W 12600 S
Ste 100
Riverton, UT 84065
Phone (801) 285-3400

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

3845 W 4700 S
West Valley City, UT 84129
Phone (801) 840-2020

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525824000000",
    "number": "1457605362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719",
            "fax_number": "480-456-0163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852827518",
            "telephone_number": "480-456-0719",
            "fax_number": "480-456-0163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "SHAWN",
        "middle_name": "D",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2018-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP8048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "751587",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.