Active NPI
Shebin Shibu
- Speech-Language Assistant
- Merrillville, IN
National Provider Identifier
1750197364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- 29002155A
- Practice address
- 407 W 61St Ave
Merrillville, IN 46410-2515 - Phone
- (219) 650-5301
- NPI assigned
- Dec 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 Assistant | 2355S0801X | 29002155A | IN | Primary |
Addresses
Primary practice location
407 W 61St Ave
Merrillville, IN 46410-2515
Mailing address
70 Ridgewood LN
Dyer, IN 46311-2165
Phone (219) 201-6505
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 |
|---|---|---|---|
| 29002155A | IN | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1733702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733702400000",
"number": "1750197364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 RIDGEWOOD LN",
"city": "DYER",
"state": "IN",
"postal_code": "463112165",
"telephone_number": "219-201-6505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 W 61ST AVE",
"city": "MERRILLVILLE",
"state": "IN",
"postal_code": "464102515",
"telephone_number": "219-650-5301"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIBU",
"first_name": "SHEBIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-12-09",
"last_updated": "2024-12-09",
"certification_date": "2024-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "IN",
"license": "29002155A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Merrillville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.