Individual provider Active NPI

Shatheta Day Roverato, C.SCD CCC SLP

  • Speech-Language Pathologist
  • Fayetteville, NC
National Provider Identifier
1861722399
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7513 Issued in NC
Practice address
111 Lamon St Ste 209
Fayetteville, NC 28301-4957
Phone
(910) 500-3015
Fax
(910) 500-3058
NPI assigned
Jan 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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 7513 NC Primary

Addresses

Primary practice location

111 Lamon St Ste 209
Fayetteville, NC 28301-4957

Mailing address

PO Box 25143
Fayetteville, NC 28314-5002
Phone (910) 929-5779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221216001516 NC Practitioner - Occupational Therapist in Private Practice 1658740634
I20241023001697 NC Practitioner - Qualified Speech Language Pathologist 1658740634

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1861722399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25143",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145002",
            "telephone_number": "910-929-5779",
            "fax_number": "910-500-3058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 LAMON ST STE 209",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014957",
            "telephone_number": "910-500-3015",
            "fax_number": "910-500-3058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROVERATO",
        "first_name": "SHATHETA",
        "middle_name": "DAY",
        "credential": "C.SCD CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-06",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.