Individual provider Active NPI

Shannon Elaine Scavarelli, CCC-SLP

  • Speech-Language Pathologist
  • Phoenix, AZ
National Provider Identifier
1881735801
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP4473 Issued in AZ
Practice address
2725 E Mine Creek Rd
1161
Phoenix, AZ 85024-6256
Phone
(480) 502-7726
Fax
(480) 513-4628
NPI assigned
Feb 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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 SLP4473 AZ Primary

Addresses

Primary practice location

2725 E Mine Creek Rd
1161
Phoenix, AZ 85024-6256

Mailing address

2725 E Mine Creek Rd
1161
Phoenix, AZ 85024-6256
Phone (480) 266-8777

Other practice location 1

108 W University Dr
Mesa, AZ 85201-5818
Phone (480) 668-1917

Other identifiers 1

IdentifierTypeStateIssuer
947137MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170104001142 AZ Practitioner - Qualified Speech Language Pathologist 0749561850 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy One, PLLC Speech-Language Pathologist CurrentSince Jul 1, 2016 Accepting new patients
Sunrise Therapy Services, Inc Speech-Language Pathologist CurrentSince Jul 1, 2018 Accepting new patients
Sunrise Therapy Services, Inc Speech-Language Pathologist CurrentSince Feb 18, 2024 Accepting new patients

Locations

108 W University Dr
Mesa, AZ 85201
Phone (480) 649-3774

4045 E Union Hills Dr
Ste 110
Phoenix, AZ 85050
Phone (602) 485-4444

4045 E Union Hills Dr
Ste 11
Phoenix, AZ 85050

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1171152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1881735801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 E MINE CREEK RD",
            "address_2": "1161",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850246256",
            "telephone_number": "480-266-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 E MINE CREEK RD",
            "address_2": "1161",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850246256",
            "telephone_number": "480-502-7726",
            "fax_number": "480-513-4628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 W University Dr",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852015818",
            "country_code": "US",
            "telephone_number": "480-668-1917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCAVARELLI",
        "first_name": "SHANNON",
        "middle_name": "ELAINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-11",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "SLP4473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "947137",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.