Shannon Bostrom, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP.0003346 Issued in CO

Practice address

2115 Grand Ave
Grand Junction, CO 81501-8007

Phone

(970) 254-4872

NPI assigned

Nov 17, 2023

Last updated

Feb 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mesa County Valley School District #51

  • Local Education Agency (LEA)
  • Grand Junction, CO
  • NPI 1851475628
  NPD

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

{
    "created_epoch": "1700179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1861267072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 424",
            "city": "MESA",
            "state": "CO",
            "postal_code": "816430424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 GRAND AVE",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018007",
            "telephone_number": "970-254-4872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTROM",
        "first_name": "SHANNON",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-17",
        "last_updated": "2024-02-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CO",
            "license": "SLP.0003346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor James Boone, NP-C
• William Glenn Bordelon, MA, LPC, LMFT
• Scott R Bordon, RPH
• Alison Lea Bormann, RN
• Molli Boruff
• Jessica S. Botkin, B.A.
• Miranda K Botts, MA, LPC, LAC
• Teresa T. Bou-Matar, LPC
• James Marcus Bougie, PHARMD
• Bounce Back Counseling Services, LLC

• Speech-Language Pathologist in Grand Junction, CO
• Providers in Grand Junction, CO by specialty
• Speech-Language Pathologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.