Shandela Hope Brewer – Developmental Therapist

Key facts

NPI: 1497315782
Entity type: Individual (NPI type 1)
Primary specialty: Developmental Therapist 222Q00000X
Practice address: 4603 Timberwalk CT
La Grange, KY 40031-6746
Phone: (502) 930-9057
NPI assigned: Jun 18, 2019
Sex: Female
Sole proprietor: No

Organizations & group practices 1

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.

Down Syndrome of Louisville, Inc. Developmental Therapist · Louisville, KY · NPI 1841498698

NPD (past) DEVELOPMENTAL THERAPIST

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Down Syndrome of Louisville, Inc.	Developmental Therapist	Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Developmental Therapist	222Q00000X		KY	Yes

Addresses

Primary practice location

4603 Timberwalk CT
La Grange, KY 40031-6746

Mailing address

11004 Marbado CT
Louisville, KY 40229-2922
Phone (502) 930-9057

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 27, 2020.

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582761600000",
    "number": "1497315782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11004 MARBADO CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292922",
            "telephone_number": "502-930-9057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4603 TIMBERWALK CT",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400316746",
            "telephone_number": "502-930-9057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "SHANDELA",
        "middle_name": "HOPE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2020-02-27",
        "certification_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Grange, KY

All providers in La Grange, KY · Developmental Therapist in Kentucky

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 27, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.