Shore Therapy Services LLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

41YS00563600 Issued in NJ

Legal business name

SHORE THERAPY SERVICES LLC

Practice address

79 Shady Nook Dr
Toms River, NJ 08755-5127

Phone

(732) 857-4473

Fax

(732) 847-4453

NPI assigned

Apr 20, 2017

Organization subpart

No

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

Authorized official

Name

Nicole Watt, SLPNPI 1245776483

Title

Ceo

Phone

(732) 857-4473

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nicole Watt

  • Speech-Language Pathologist
  • Toms River, NJ
  • NPI 1245776483
  Medicare reassignment Authorized official
• Megan K Donovan

  • Speech-Language Pathologist
  • Toms River, NJ
  • NPI 1659942886
  NPD
• Kathryn McDonald

  • Speech-Language Pathologist
  • Toms River, NJ
  • NPI 1568370567
  NPD (past)

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

{
    "created_epoch": "1492646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1790219392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 SHADY NOOK DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555127",
            "telephone_number": "732-857-4473",
            "fax_number": "732-847-4453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 SHADY NOOK DR",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087555127",
            "telephone_number": "732-857-4473",
            "fax_number": "732-847-4453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-20",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "WATT",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-857-4473",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00563600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Shore Touch Pediatrics, LLC
• Joseph T Shore
• Shoreline Chiropractic LLC (Carskaddan Chiropractic)
• Shoremedical5 LLC
• Olubunmi Adejumoke Shoyele, M.D

• Speech-Language Pathologist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Speech-Language Pathologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.

Verify at the official NPI Registry.