Shewan Michelle Martin, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

04257 Issued in MD

Practice address

4445 Corporation Lane
Suite 264
Virginia Beach, VA 23462-6584

Phone

(443) 454-2021

Fax

(410) 224-7637

NPI assigned

Oct 21, 2005

Reactivated

Mar 1, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1528058591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "city": "STAFFORD",
            "state": "VA",
            "postal_code": "225550516",
            "telephone_number": "443-454-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LANE",
            "address_2": "SUITE 264",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234626584",
            "telephone_number": "443-454-2021",
            "fax_number": "410-224-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHEWAN",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "deactivation_date": "2016-01-11",
        "reactivation_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "04257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Martin
• Richard A Martin, OD
• Shana L Martin, LPN
• Sheldene J Martin
• Shelly Martin, M.A. CCC-SLP
• Theresa Anne Martin
• Tracey Curtis Martin
• Trent D Martin, M.D.
• Victoria Remington Martin, NP
• William L Martin, M.D.

• Speech-Language Pathologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; 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.