Active NPI
Shannon McNally, CCC-SLP
- Speech-Language Pathologist
- Plymouth, MI
National Provider Identifier
1811461114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 08864
- Practice address
- 801 W Ann Arbor TRL Ste 200
Plymouth, MI 48170-1694 - Phone
- (716) 445-0449
- NPI assigned
- Jan 20, 2019
- 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 | 08864 | MD | Primary |
Addresses
Primary practice location
801 W Ann Arbor TRL Ste 200
Plymouth, MI 48170-1694
Mailing address
88 Green Forest CT
East Amherst, NY 14051-1374
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 |
|---|---|---|---|
| 08864 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1547942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1547942400000",
"number": "1811461114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 GREEN FOREST CT",
"city": "EAST AMHERST",
"state": "NY",
"postal_code": "140511374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "801 W ANN ARBOR TRL STE 200",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701694",
"telephone_number": "716-445-0449"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNALLY",
"first_name": "SHANNON",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-20",
"last_updated": "2019-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "08864",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.