Individual provider Active NPI

Beth-Ann Kershaw Shell, MA, CCC-SLP

  • Speech-Language Pathologist
  • St Petersburg, FL
National Provider Identifier
1780078774
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA7326 Issued in FL
Practice address
111 2ND Ave NE
St Petersburg, FL 33701-3434
Phone
(813) 690-1327
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA7326 FL Primary

Addresses

Primary practice location

111 2ND Ave NE
St Petersburg, FL 33701-3434

Mailing address

8233 Caponata Blvd
Seminole, FL 33777-4469
Phone (813) 504-3717

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)
Enrolled
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1780078774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8233 CAPONATA BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774469",
            "telephone_number": "813-504-3717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 2ND AVE NE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013434",
            "telephone_number": "813-690-1327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELL",
        "first_name": "BETH-ANN",
        "middle_name": "KERSHAW",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 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.

Verify at the official NPI Registry.