Active NPI
Shelita Lebrina Reid Santana, M.ED., CCC-SLP
- Speech-Language Pathologist
- Fayetteville, NC
National Provider Identifier
1922387778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 8982
- Practice address
- 1211A Ireland Dr
Fayetteville, NC 28304-3372 - Phone
- (910) 912-2201
- Fax
- (910) 486-1590
- NPI assigned
- Aug 11, 2011
- Last updated
- Jul 14, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 8982 | NC | Primary |
Addresses
Primary practice location
1211A Ireland Dr
Fayetteville, NC 28304-3372
Mailing address
1211A Ireland Dr
Fayetteville, NC 28304-3372
Phone (910) 912-2201
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8982 | Other | NC | STATE OF NORTH CAROLINA BOARD OF EXAMINERS FOR SPEECH AND LANGUAGE PATHOLOGISTS |
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8982 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626220800000",
"number": "1922387778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1211A IRELAND DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043372",
"telephone_number": "910-912-2201",
"fax_number": "910-486-1590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1211A IRELAND DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283043372",
"telephone_number": "910-912-2201",
"fax_number": "910-486-1590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REID SANTANA",
"first_name": "SHELITA",
"middle_name": "LEBRINA",
"name_prefix": "Ms.",
"credential": "M.ED., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-11",
"last_updated": "2021-07-14",
"certification_date": "2021-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "8982",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF NORTH CAROLINA BOARD OF EXAMINERS FOR SPEECH AND LANGUAGE PATHOLOGISTS",
"identifier": "8982",
"state": "NC"
}
],
"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 Jul 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.