Individual provider Active NPI

Kelly Shotts, M.S. SLP

  • Speech-Language Pathologist
  • Virginia Beach, VA
National Provider Identifier
1093351876
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202009539 Issued in VA
Practice address
4772 Euclid Rd Ste C
Virginia Beach, VA 23462-3800
Phone
(757) 615-2684
Fax
(757) 540-1126
NPI assigned
Nov 27, 2019
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202009539 VA Primary

Addresses

Primary practice location

4772 Euclid Rd Ste C
Virginia Beach, VA 23462-3800

Mailing address

412 Gotham Rd
Virginia Beach, VA 23452-2429
Phone (757) 615-2684

Other names 1

  • Kelly Kirby Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200114001889 VA Practitioner - Qualified Speech Language Pathologist 8921433285 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202009539VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Resolute Therapy Collaborative, LLC Speech-Language Pathologist CurrentSince Aug 28, 2022 Accepting new patients
JP Therapy, LLC CurrentSince Dec 15, 2019 Accepting new patients

Locations

4772 Euclid Rd
Ste C
Virginia Beach, VA 23462
Phone (757) 606-0987

5604 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23462

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1093351876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 GOTHAM RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234522429",
            "telephone_number": "757-615-2684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4772 EUCLID RD STE C",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623800",
            "telephone_number": "757-615-2684",
            "fax_number": "757-540-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOTTS",
        "first_name": "KELLY",
        "credential": "M.S. SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-27",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202009539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "KIRBY",
            "credential": "M.S. SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; 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.