Individual provider Active NPI

Kelly Shenk, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Harrisonburg, VA
National Provider Identifier
1104331248
Registry record updated Dec 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202001509 Issued in VA
Practice address
451 Chicago Ave
Harrisonburg, VA 22802-2203
Phone
(540) 434-8352
Fax
(540) 434-9996
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2017

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 2202001509 VA Primary

Addresses

Primary practice location

451 Chicago Ave
Harrisonburg, VA 22802-2203

Mailing address

451 Chicago Ave
Harrisonburg, VA 22802-2203
Phone (540) 434-8352

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

LicenseStateTypeSpecialty
2202001509VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1104331248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 CHICAGO AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228022203",
            "telephone_number": "540-434-8352",
            "fax_number": "540-434-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 CHICAGO AVE",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228022203",
            "telephone_number": "540-434-8352",
            "fax_number": "540-434-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHENK",
        "first_name": "KELLY",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202001509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.