Active NPI
Rebecca Harrell-Bishir, M.A. CCC-SLP
- Speech-Language Pathologist
- Peru, IN
National Provider Identifier
1710003629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA 7434
- Practice address
- 1332 N Raccoon Hill Rd
Peru, IN 46970-7670 - Phone
- (765) 460-7645
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA 7434 | FL | Primary |
| Speech-Language Pathologist | 235Z00000X | 22005872A | IN |
Addresses
Primary practice location
1332 N Raccoon Hill Rd
Peru, IN 46970-7670
Mailing address
1332 N Raccoon Hill Rd
Peru, IN 46970-7670
Phone (765) 460-7645
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 890848600 | Medicaid | FL |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SA 7434 | FL | MD | Speech-Language Pathologist |
| 22005872A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449532800000",
"number": "1710003629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1332 N RACCOON HILL RD",
"city": "PERU",
"state": "IN",
"postal_code": "469707670",
"telephone_number": "765-460-7645"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1332 N RACCOON HILL RD",
"city": "PERU",
"state": "IN",
"postal_code": "469707670",
"telephone_number": "765-460-7645"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL-BISHIR",
"first_name": "REBECCA",
"credential": "M.A. CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2015-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 7434",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22005872A",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "890848600",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peru, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.