MEDICARE: SHANNON ELYSE BOTHWELL M.S. SLP-CFY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	46002739A	IN

General Provider Information

NPI Number	:	1205215407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON ELYSE BOTHWELL M.S. SLP-CFY

Provider Business Mailing Address
First Line	:	11236 N US HIGHWAY 231
Second Line	:
City	:	ODON
State	:	IN
Zip	:	47562-5602
Country	:	US
Telephone Number	:	812-486-8596
Fax Number	:

Provider Business Practice Location Address
First Line	:	6239 S EAST ST STE A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-2088
Country	:	US
Telephone Number	:	317-442-4734
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2015
Last Update Date	:	05/21/2015

Similar Medicare Providers

1366047854 — MRS. MARY ROSE HAMM
Practice Location Address:

6239 S EAST ST STE A
INDIANAPOLIS, IN
46227-2088

Practice Phone: 260-328-5074
Practice Fax:

1710018783 — MRS. CASSANDRA ELIZABETH CRUTCHFIELD
Practice Location Address:

6239 S EAST ST STE I
INDIANAPOLIS, IN
46227-2088

Practice Phone: 317-270-0522
Practice Fax: 317-791-9001

1447377809 — MELISSA HUBBARD PT
Practice Location Address:

6239 S EAST ST STE A
INDIANAPOLIS, IN
46227-2088

Practice Phone: 317-791-9031
Practice Fax: 317-791-9001

1306002324 — SUZANNE M GANO
Practice Location Address:

6239 S EAST ST STE A
INDIANAPOLIS, IN
46227-2088

Practice Phone: 317-791-9031
Practice Fax:

1629329354 — REBECCA C WATTS SLP
Practice Location Address:

6239 S EAST ST STE A
INDIANAPOLIS, IN
46227-2088

Practice Phone: 317-791-9031
Practice Fax:

1881045037 — CHLOE CALENZO
Practice Location Address:

6239 S EAST ST STE G
INDIANAPOLIS, IN
46227-2088

Practice Phone: 317-561-1888
Practice Fax: 317-791-9001

Directions to “ SHANNON ELYSE BOTHWELL M.S. SLP-CFY” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.