Active NPI
Melanie Renee Shannon
- Speech-Language Pathologist
- Stoneboro, PA
National Provider Identifier
1467653832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SL005717L
- Practice address
- 2079 District Rd
Stoneboro, PA 16153-2011 - Phone
- (724) 376-2649
- NPI assigned
- May 31, 2007
- 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 Pathologist | 235Z00000X | SL005717L | PA | Primary |
Addresses
Primary practice location
2079 District Rd
Stoneboro, PA 16153-2011
Mailing address
2079 District Rd
Stoneboro, PA 16153-2011
Phone (724) 376-2649
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 |
|---|---|---|---|
| SL005717L | PA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467653832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2079 DISTRICT RD",
"city": "STONEBORO",
"state": "PA",
"postal_code": "161532011",
"telephone_number": "724-376-2649"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2079 DISTRICT RD",
"city": "STONEBORO",
"state": "PA",
"postal_code": "161532011",
"telephone_number": "724-376-2649"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANNON",
"first_name": "MELANIE",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "PA",
"license": "SL005717L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stoneboro, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.