Active NPI
Shelley Elizabeth Gordon, CCC-SLP
- Speech-Language Pathologist
- Stafford, TX
National Provider Identifier
1649756750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 111806
- Practice address
- 12371 S Kirkwood Rd
Stafford, TX 77477-2836 - Phone
- (713) 995-9292
- Fax
- (713) 779-0204
- NPI assigned
- Jul 12, 2018
- Sex
- Female
- Sole proprietor
- No
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 | 111806 | TX | Primary |
Addresses
Primary practice location
12371 S Kirkwood Rd
Stafford, TX 77477-2836
Mailing address
5618 Walnut Glen LN
Rosenberg, TX 77471-2683
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 |
|---|---|---|---|
| 111806 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1649756750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5618 WALNUT GLEN LN",
"city": "ROSENBERG",
"state": "TX",
"postal_code": "774712683"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12371 S KIRKWOOD RD",
"city": "STAFFORD",
"state": "TX",
"postal_code": "774772836",
"telephone_number": "713-995-9292",
"fax_number": "713-779-0204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "SHELLEY",
"middle_name": "ELIZABETH",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "111806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stafford, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.