Individual provider Active NPI

Samantha Alexis Katherine Shands, CCC-SLP

  • Speech-Language Pathologist
  • Arden Hills, MN
National Provider Identifier
1992542526
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
528623 Issued in MN
Practice address
6 Pine Tree Dr
Arden Hills, MN 55112-3745
Phone
(651) 639-0942
NPI assigned
Jul 11, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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 528623 MN Primary

Addresses

Primary practice location

6 Pine Tree Dr
Arden Hills, MN 55112-3745

Mailing address

6 Pine Tree Dr
Arden Hills, MN 55112-3745
Phone (651) 639-0942

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240807000765 MN Practitioner - Qualified Speech Language Pathologist 3678010741 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Speech and Language Specialists LLC Speech-Language Pathologist CurrentSince Jul 1, 2024 Accepting new patients
Associated Speech and Language Past Accepting new patients

Locations

3021 Harbor Ln N
Ste 120
Plymouth, MN 55447
Phone (651) 773-0354

2395 Ariel St N
#B
Saint Paul, MN 55109
Phone (651) 773-3208

561 7th St W
Saint Paul, MN 55102
Phone (651) 225-4558

6 Pine Tree Dr
Ste 330
Saint Paul, MN 55112
Phone (651) 639-0942

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.

NPI Registry JSON

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1992542526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PINE TREE DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551123745",
            "telephone_number": "651-639-0942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PINE TREE DR",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551123745",
            "telephone_number": "651-639-0942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANDS",
        "first_name": "SAMANTHA",
        "middle_name": "ALEXIS KATHERINE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "528623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arden Hills, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.