Active NPI
Shaina Magwaza
- Speech-Language Pathologist
- Mishawaka, IN
National Provider Identifier
1790660983
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 03199L
- Practice address
- 12720 Jefferson Blvd
Mishawaka, IN 46545-7620 - Phone
- (312) 898-1290
- NPI assigned
- Aug 7, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 03199L | MD | Primary |
Addresses
Primary practice location
12720 Jefferson Blvd
Mishawaka, IN 46545-7620
Mailing address
12720 Jefferson Blvd
Mishawaka, IN 46545-7620
Phone (312) 898-1289
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 |
|---|---|---|---|
| 03199L | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754524800000",
"number": "1790660983",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12720 JEFFERSON BLVD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465457620",
"telephone_number": "312-898-1289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12720 JEFFERSON BLVD",
"city": "MISHAWAKA",
"state": "IN",
"postal_code": "465457620",
"telephone_number": "312-898-1290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGWAZA",
"first_name": "SHAINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-07",
"last_updated": "2025-08-07",
"certification_date": "2025-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "03199L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mishawaka, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.