Individual provider Active NPI

Shelby Betzold

  • Speech-Language Assistant
  • Fort Myers, FL
National Provider Identifier
1508731977
Registry record updated Oct 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
SI8001 Issued in FL
Practice address
3880 Colonial Blvd Ste 2
Fort Myers, FL 33966-1062
Phone
(239) 351-3715
Fax
(239) 310-2045
NPI assigned
Oct 7, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Assistant 2355S0801X SI8001 FL Primary

Addresses

Primary practice location

3880 Colonial Blvd Ste 2
Fort Myers, FL 33966-1062

Mailing address

1829 Nicollett Ave
North Port, FL 34286-2035
Phone (513) 885-3306

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

LicenseStateTypeSpecialty
SI8001FLMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stepping Stone Kids Therapy LLC CurrentSince Oct 12, 2025 Accepting new patients

Locations

3880 Colonial Blvd
Ste 2
Fort Myers, FL 33966
Phone (239) 351-3715

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.

NPI Registry JSON

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

{
    "created_epoch": "1759795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1508731977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1829 NICOLLETT AVE",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862035",
            "telephone_number": "513-885-3306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 COLONIAL BLVD STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661062",
            "telephone_number": "239-351-3715",
            "fax_number": "239-310-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETZOLD",
        "first_name": "SHELBY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "FL",
            "license": "SI8001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; 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.