Individual provider Active NPI

Shannon Reilly, CCC-SLP

  • Speech-Language Pathologist
  • Clearwater, FL
National Provider Identifier
1982483020
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA21650 Issued in FL
Practice address
620 Belleair Rd
Clearwater, FL 33756-2106
Phone
(727) 761-4792
NPI assigned
Sep 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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 SA21650 FL Primary

Addresses

Primary practice location

620 Belleair Rd
Clearwater, FL 33756-2106

Mailing address

620 Belleair Rd
Clearwater, FL 33756-2106

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231019003797 FL Practitioner - Qualified Speech Language Pathologist 8426404989 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3201 1St St NE
St Petersburg, FL 33704-2205
Phone (727) 390-3675

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Sep 25, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC Speech-Language Pathologist CurrentSince Oct 11, 2023 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Speech-Language Pathologist CurrentSince Sep 25, 2023 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Oct 11, 2023 Accepting new patients

Locations

620 Belleair Rd
Clearwater, FL 33756
Phone (727) 467-9464

6945 Carlisle Ct
Naples, FL 34109
Phone (239) 249-6877

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 4

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": "1695772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1982483020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BELLEAIR RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BELLEAIR RD",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337562106",
            "telephone_number": "727-761-4792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHANNON",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA21650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.