Shana L Kelly, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00003194 Issued in WA

Practice address

4115 University Way NE
Ste 202
Seattle, WA 98105-6257

Phone

(206) 299-1780

Fax

(206) 524-9836

NPI assigned

Feb 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Shana L Kelly Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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

• Children'S Communication Corner

  • Speech-Language Pathologist
  • Seattle, WA
  • NPI 1093097503
  NPD (past) Authorized official
• Childrens Communication Corner Inc

  • Speech-Language Pathologist
  • Seattle, WA
  • NPI 1508829052
  NPD (past) Authorized official

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1235277997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4115 UNIVERSITY WAY NE",
            "address_2": "STE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056257",
            "telephone_number": "206-299-1780",
            "fax_number": "206-524-9836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4115 UNIVERSITY WAY NE",
            "address_2": "STE 202",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056257",
            "telephone_number": "206-299-1780",
            "fax_number": "206-524-9836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHANA",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7115272",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "204367673",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDREN'S COMMUNICATION CORNER NPI",
            "identifier": "1508829052",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "6704KE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANA",
            "last_name": "KELLY",
            "middle_name": "L",
            "credential": "M.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Patricia Rose Kelly, DMD
• Paul Kelly
• Rosemary Helena Kelly, M.D.
• Samantha Kelly
• Scott M Kelly, M.D.
• Sheila D Kelly
• Tara Marie Kelly, M.S., CCC-SLP
• Valerie E. Kelly, PT, PHD
• Kelsey Anderson Counseling, PLLC
• Kelsey Johnson Counseling, LLC

• Speech-Language Pathologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2014; 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.