Individual provider Active NPI

Shayna K Pons, MS, CCC/SLP

  • Speech-Language Pathologist
  • Lewisville, NC
National Provider Identifier
1629457692
Registry record updated May 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4445 Issued in NC
Practice address
8800 Buckey CT
Lewisville, NC 27023-7745
Phone
(336) 407-2648
NPI assigned
May 23, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2015

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 4445 NC Primary

Addresses

Primary practice location

8800 Buckey CT
Lewisville, NC 27023-7745

Mailing address

8800 Buckey CT
Lewisville, NC 27023-7745

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
4445NCMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1432339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432339200000",
    "number": "1629457692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 BUCKEY CT",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270237745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 BUCKEY CT",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270237745",
            "telephone_number": "336-407-2648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONS",
        "first_name": "SHAYNA",
        "middle_name": "K",
        "credential": "MS, CCC/SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-23",
        "last_updated": "2015-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2015; 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.