Active NPI
Rachel Shishov
- Speech-Language Pathologist
- Palm Beach Gardens, FL
National Provider Identifier
1861791527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SA21309
- Practice address
- 347 Hiatt Dr
Palm Beach Gardens, FL 33418-7106 - Phone
- (561) 621-4366
- NPI assigned
- Mar 21, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SA21309 | FL | Primary |
| Speech-Language Pathologist | 235Z00000X | NY |
Addresses
Primary practice location
347 Hiatt Dr
Palm Beach Gardens, FL 33418-7106
Mailing address
9638 Shepard PL
Wellington, FL 33414-6420
Phone (631) 836-4747
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681776000000",
"number": "1861791527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9638 SHEPARD PL",
"city": "WELLINGTON",
"state": "FL",
"postal_code": "334146420",
"telephone_number": "631-836-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "347 HIATT DR",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334187106",
"telephone_number": "561-621-4366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHISHOV",
"first_name": "RACHEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-21",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA21309",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm Beach Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.