Katelyn Ricketts, MS, CCC-SLP, IBCLC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

114013 Issued in TX

Practice address

2001 N Loy Lake Rd Ste J
Sherman, TX 75090-2837

Phone

(903) 487-5520

NPI assigned

Feb 3, 2021

Last updated

Feb 3, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Katelyn Klug Former name

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Perdue Therapy Group LLC

  dba Perdue Works Therapy Group

  • Pediatric Occupational Therapist
  • Sherman, TX
  • NPI 1972133312

  Multi-Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612310400000",
    "number": "1083206874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N LOY LAKE RD STE J",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750902837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 N LOY LAKE RD STE J",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750902837",
            "telephone_number": "903-487-5520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICKETTS",
        "first_name": "KATELYN",
        "credential": "MS, CCC-SLP, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114013",
            "primary": true
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NU",
            "license": "L-301926",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "KLUG",
            "credential": "MS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jawad Riaz, M.D.
• Richard D. Jelsma, MD, PA
• Matthew Scott Richardson, PA-C
• Regan Richey
• Charles Hunter Richmond, MD
• Clarissa Reshel Ricks, LMT
• Julia Marie Ridenour, LPC, LPA
• Veronica Riera-Gilley, PHARM.D.
• Brett Douglas Ringger, O.D.
• Naif John Risk

• Speech-Language Pathologist in Sherman, TX
• Providers in Sherman, TX by specialty
• Speech-Language Pathologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.