Kelly Ann Shaughnessy, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP31566 Issued in CA

Practice address

3031 W March LN # 17
Stockton, CA 95219-6500

Phone

(209) 952-2588

NPI assigned

Jan 7, 2021

Last updated

Aug 23, 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Gift of Speech, a Professional Speech-Language Pathology Corporati

  • Speech-Language Pathologist
  • Stockton, CA
  • NPI 1699953539

  Single Specialty

  NPD (past)
• Ergonomic Consultants, LLC

  dba RehabVisions

  • Multi-Specialty Clinic/Center
  • McAlester, OK
  • NPI 1922039882

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1275121006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 14TH PL S",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973062107",
            "telephone_number": "503-409-4754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W MARCH LN # 17",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196500",
            "telephone_number": "209-952-2588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAUGHNESSY",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "013223",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP31566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "2099522544",
            "affiliation": "N",
            "endpointDescription": "fax Gift of Speech",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3031 W March Ln Ste 117",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952196568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sonal Sharma, B.A.
• Vishal Sharma, M.B.B.S.
• Sharon a. Manaois, DDS, Inc.
• Angela Catherine Sharp
• Rashida Michele Sharp
• Muhammad Usama Shauib, MD
• Khephra A Shaw-Meredith
• Cherina Shaw, E-RYT 500
• Mary Anne Habel Shaw
• Penelope Shaw

• Speech-Language Pathologist in Stockton, CA
• Providers in Stockton, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.