Active NPI
Shannon Amber Kallsen, M.S.
- Speech-Language Pathologist
- Addison, TX
National Provider Identifier
1003308693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 114495
- Practice address
- 15820 Addison Rd
Addison, TX 75001-3549 - Phone
- (866) 919-3240
- NPI assigned
- May 31, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 114495 | TX | Primary |
Addresses
Primary practice location
15820 Addison Rd
Addison, TX 75001-3549
Mailing address
4409 Travis St Apt C
Dallas, TX 75205-4117
Phone (505) 385-5571
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 114495 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527724800000",
"number": "1003308693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 TRAVIS ST APT C",
"city": "DALLAS",
"state": "TX",
"postal_code": "752054117",
"telephone_number": "505-385-5571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15820 ADDISON RD",
"city": "ADDISON",
"state": "TX",
"postal_code": "750013549",
"telephone_number": "866-919-3240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALLSEN",
"first_name": "SHANNON",
"middle_name": "AMBER",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-31",
"last_updated": "2018-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "114495",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Addison, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.