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SHANESE CAMPBELL CCC-SLP
NPI 1124745617
Speech-Language Pathologist in West Park, FL

Active since October 25, 2022
4008 SW 27TH ST, WEST PARK, FL 33023(954) 864-4511 Get Directions Write a Review

NPPES record last updated: October 25, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Shanese Campbell Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANESE CAMPBELL CCC-SLP (NPI 1124745617) is an individual speech-language pathologist provider in West Park, Florida, licensed in Florida (SA20870) and active in the NPI registry since October 2022. She is a graduate of Other (2021).

NPPES Registry Identity

NPI1124745617
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameSHANESE CAMPBELLCredential: CCC-SLP
Location Address4008 SW 27TH STWest Park, FL 33023-4468
Mailing Address4008 Sw 27th StWest Park, FL 33023-4468 · (954) 864-4511
Phone(954) 864-4511
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 25, 2022
NPPES CertifiedOctober 25, 2022
✔ NPI 1124745617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in FL · SA20870
Definition
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.
4008 SW 27TH ST, West Park, FL 33023
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shanese Campbell Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032604368
PECOS Enrollment IDI20251223003591

Medicare Billing Reassignment

Medicare enrollment records show Shanese Campbell reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Legacy Speech Services L.L.C.
971 mi
Speech-Language Pathologist
2026 WIRT RD, SUITE 103B
Houston, TX 77055
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Legacy Speech Services LLC
  • 4 clinicians in this Medicare group
NPI 1427451145 (201) 213-2461

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NEW HORIZONS SPEECH & LANGUAGE THERAPY, LLC
Speech-Language Pathologist
4008 SW 27TH ST
WEST PARK, FL 33023
Broward County (954) 864-4511

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shanese Campbell's NPI number?

The NPI number for Shanese Campbell is 1124745617. It was assigned to this individual provider in the NPPES registry on October 25, 2022.

Where is Shanese Campbell located?

Shanese Campbell practices at 4008 SW 27th St, West Park, FL 33023. The listed phone number is (954) 864-4511.

What is Shanese Campbell's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Shanese Campbell enrolled in Medicare?

Yes. Shanese Campbell is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Shanese Campbell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Shanese Campbell reassigns Medicare benefits to Legacy Speech Services L.L.C. (Houston, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Shanese Campbell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Shanese Campbell accept?

Health plans from Blue Cross and Blue Shield of Texas and UnitedHealthcare list Shanese Campbell as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shanese Campbell was last updated on October 25, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.