Active NPI
Shanna Nicole Stoller
- Speech-Language Assistant
- Mesa, AZ
National Provider Identifier
1942553326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Assistant
- License
- SLPA7823
- Practice address
- 1745 S Alma School Rd
Suite 145
Mesa, AZ 85210-3009 - Phone
- (480) 963-3634
- NPI assigned
- Oct 22, 2012
- 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 Assistant | 2355S0801X | SLPA7823 | AZ | Primary |
Addresses
Primary practice location
1745 S Alma School Rd
Suite 145
Mesa, AZ 85210-3009
Mailing address
16827 S 1St Dr
Phoenix, AZ 85045-0723
Phone (602) 793-6969
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLPA7823 | AZ | MD | Speech-Language Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baio Enterprises | Past | Accepting new patients | |
| Baio Enterprises Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Speech-Language Pathologist
- Mesa, AZ
- NPI 1477801686
-
- Developmental Disabilities Clinic/Center
- Mesa, AZ
- NPI 1457421604
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1350864000000",
"number": "1942553326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16827 S 1ST DR",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850450723",
"telephone_number": "602-793-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1745 S ALMA SCHOOL RD",
"address_2": "SUITE 145",
"city": "MESA",
"state": "AZ",
"postal_code": "852103009",
"telephone_number": "480-963-3634"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STOLLER",
"first_name": "SHANNA",
"middle_name": "NICOLE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-22",
"last_updated": "2012-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "2355S0801X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Speech-Language Assistant",
"state": "AZ",
"license": "SLPA7823",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.