Individual provider Active NPI

Maryum Shaheed, SLP ASSISTANT

  • Speech-Language Assistant
  • Weatherford, TX
National Provider Identifier
1700348810
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language AssistantTaxonomy code 2355S0801X
License
40831 Issued in TX
Practice address
1629 Russell Bend Rd
Weatherford, TX 76088-1211
Phone
(817) 705-8639
NPI assigned
Apr 5, 2019
Last updated
Apr 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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 40831 TX Primary

Addresses

Primary practice location

1629 Russell Bend Rd
Weatherford, TX 76088-1211

Mailing address

1629 Russell Bend Rd
Weatherford, TX 76088-1211
Phone (817) 705-8639

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
40831TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1554422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1700348810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 RUSSELL BEND RD",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760881211",
            "telephone_number": "817-705-8639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 RUSSELL BEND RD",
            "city": "WEATHERFORD",
            "state": "TX",
            "postal_code": "760881211",
            "telephone_number": "817-705-8639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHEED",
        "first_name": "MARYUM",
        "credential": "SLP ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-05",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2355S0801X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Speech-Language Assistant",
            "state": "TX",
            "license": "40831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weatherford, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2019; 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.