SHANNON NICOLE BRODERICK (NPI# 1447750351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447750351 |
| Entity Type | Individual |
| Full Name | SHANNON NICOLE BRODERICK |
| Practice Address |
4668 Pembroke Blvd Ste 115 Virginia Beach VA 23455-6423 |
| Mailing Address |
1377 Motor Pkwy Ste 307 Islandia NY 11749-5258 |
| Practice Telephone | 7579324261 |
| Mailing Telephone | 6315805200 |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2020-07-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7552 Navarre Pkwy Unit 32, Navarre, FL 325667308 | 8509393944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972016855 | Shannon Broderick | Behavior Technician | 64 Bradford St, Abington, MA 02351 | 2017-11-14 |
| 1386096790 | Shannon Broderick | Social Worker | 529 Se 2nd St Ste D, Lees Summit, MO 64063-2654 | 2016-07-09 |
| Street Address |
4668 PEMBROKE BLVD STE 115 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23455-6423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740233436 | Stephanie Ricard Roberts | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2006-05-17 |
| 1376152819 | Mariah M Rees | Occupational Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2020-07-30 |
| 1770137291 | Chelsea Lindo Lindo | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2019-08-01 |
| 1780151704 | Catherine Llewellyn | Occupational Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-10-29 |
| 1508349960 | Bridgette Nicole Nehlen | Speech-Language Pathologist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-09-12 |
| 1003398991 | Lindsey Pauley | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-09-06 |
| 1104304815 | Dustin Yaworski | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-08-03 |
| 1811475874 | Mark Halvorsen | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-08-01 |
| 1043797715 | Jennifer Berry | Physical Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-07-25 |
| 1477039238 | Chelsea Lambright | Occupational Therapist | 4668 Pembroke Blvd Ste 115, Virginia Beach, VA 23455-6423 | 2018-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093324162 | Evoscient Gynecology Center for Pelvic Health and Surgery, PC | Obstetrics & Gynecology | 108 Independence Blvd, Suite 162, Virginia Beach, VA 23455 | 2020-07-24 |
| 1942728571 | Delois L Dillard | Occupational Therapy Assistant | 4225 Shore Drive, Virginia Beach, VA 23455 | 2017-09-04 |
| 1295255404 | Unobs Medical Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5812 Tajo Avenue, Virginia Beach, VA 23455 | 2017-06-20 |
| 1831640812 | Wearefit | Dietitian, Registered | 4752 Hollis Road, Virginia Beach, VA 23455 | 2016-10-14 |
| 1629496633 | Jamie Lauren Dermatis | Podiatrist | 1700 Pleasure Road, #101, Virginia Beach, VA 23455 | 2014-04-07 |
| 1619304664 | Syed A Absar | Pharmacist | 4828 Lake Bradford Lane, Virginia Beach, VA 23455 | 2013-10-07 |
| 1851734958 | Cara K Richardson | Occupational Therapist | 2364 Madison Ave., Virginia Beach, VA 23455 | 2013-04-09 |
| 1811249287 | Chl & Associates | Nurse Practitioner | 1367 Sir Richard Rd, Virginia Beach, VA 23455 | 2012-10-10 |
| 1588915425 | Edward S Wilson | Physician Assistant | 604 Bishop Dr, Virginia Beach, VA 23455 | 2012-10-01 |
| 1073886842 | April Gilbrech | Registered Nurse | 1103 Canopy Ct, Virginia Beach, VA 23455 | 2012-02-09 |
| Find all providers in zip 23455 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547268 | Brynn Arica Carey | Speech-Language Pathologist | Laskin Road Annex, 1413 Laskin Road, Virginia Beach, VA 23451 | 2020-10-29 |
| 1124646278 | Minichiello Therapy Services | Speech-Language Pathologist | 4312 Madison Mews Dr, Virginia Beach, VA 23456-8242 | 2020-07-06 |
| 1447807656 | Andrea Elizabeth Crowley | Speech-Language Pathologist | 645 Declaration Rd, Virginia Beach, VA 23462-2252 | 2019-08-22 |
| 1790255198 | Michael Mascolo | Speech-Language Pathologist | 2213 Round Hill Dr, Virginia Beach, VA 23464-8855 | 2018-11-28 |
| 1790255149 | Mary Judith Weaver | Speech-Language Pathologist | 1716 Grey Friars Chase, Virginia Beach, VA 23456-5435 | 2018-11-28 |
| 1356810774 | Gretchen Himes | Speech-Language Pathologist | 601 S Lynnhaven Rd, Virginia Beach, VA 23452-6536 | 2018-11-14 |
| 1659850311 | Sonia Carmen Violette | Speech-Language Pathologist | 5301 Providence Rd Ste 80&90, Virginia Beach, VA 23464-4128 | 2018-08-13 |
| 1265927123 | Rita Bland | Speech-Language Pathologist | 4508 Harshaw Ct, Virginia Beach, VA 23456-4849 | 2018-06-24 |
| 1437656949 | Tonya Jill Macdonald | Speech-Language Pathologist | 3532 Kings Grant Rd, Virginia Beach, VA 23452-4531 | 2018-04-11 |
| 1902301575 | Erin Kathleen Cooper | Speech-Language Pathologist | 1257 Rosemont Rd, Virginia Beach, VA 23453-2119 | 2018-03-27 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23455 |
Please comment or provide details below to improve the information on SHANNON NICOLE BRODERICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.