Active NPI
Shelby Rae Martin, MS CCC-SLP
- Speech-Language Pathologist
- Birmingham, AL
National Provider Identifier
1760973192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4247
- Practice address
- 120 Oslo Cir
Birmingham, AL 35211-5965 - Phone
- (205) 944-3939
- NPI assigned
- May 21, 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 | 4247 | AL | Primary |
Addresses
Primary practice location
120 Oslo Cir
Birmingham, AL 35211-5965
Mailing address
2328 Derby Dr
Vestavia Hills, AL 35216-4263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190305003509 | AL | Practitioner - Qualified Speech Language Pathologist | 5092054262 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4247 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1526860800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1526860800000",
"number": "1760973192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2328 DERBY DR",
"city": "VESTAVIA HILLS",
"state": "AL",
"postal_code": "352164263"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 OSLO CIR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352115965",
"telephone_number": "205-944-3939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SHELBY",
"middle_name": "RAE",
"credential": "MS CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-21",
"last_updated": "2018-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AL",
"license": "4247",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.