Individual provider Active NPI

Shelley C Jansky, SLP

  • Speech-Language Pathologist
  • Victoria, TX
National Provider Identifier
1932471950
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
104931 Issued in TX
Practice address
4208 Retama Cir
Victoria, TX 77901-2765
Phone
(361) 582-0611
Fax
(361) 582-0555
NPI assigned
Feb 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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 104931 TX Primary

Addresses

Primary practice location

4208 Retama Cir
Victoria, TX 77901-2765

Mailing address

4208 Retama Cir
Victoria, TX 77901-2765
Phone (361) 582-0611

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

State licenses

LicenseStateTypeSpecialty
104931TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1932471950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4208 RETAMA CIR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012765",
            "telephone_number": "361-582-0611",
            "fax_number": "361-582-0555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 RETAMA CIR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779012765",
            "telephone_number": "361-582-0611",
            "fax_number": "361-582-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSKY",
        "first_name": "SHELLEY",
        "middle_name": "C",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-07",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "104931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.