Individual provider Active NPI

Shaigna Wentz, CCC-SLP

  • Speech-Language Pathologist
  • Gainesville, GA
National Provider Identifier
1295501187
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3002168 Issued in NC
Practice address
508 Oak St Ste 2
Gainesville, GA 30501-3576
Phone
(770) 536-5275
NPI assigned
Nov 30, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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 3002168 NC Primary

Addresses

Primary practice location

508 Oak St Ste 2
Gainesville, GA 30501-3576

Mailing address

70 Overview Dr
Otto, NC 28763
Phone (828) 280-9695

Other practice location 1

193 Asheville Hwy
Sylva, NC 28779-2731
Phone (828) 586-8935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240626001344 NC Practitioner - Qualified Speech Language Pathologist 8628512183 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3002168NCMDSpeech-Language Pathologist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1295501187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 OVERVIEW DR",
            "city": "OTTO",
            "state": "NC",
            "postal_code": "28763",
            "telephone_number": "828-280-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 OAK ST STE 2",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013576",
            "telephone_number": "770-536-5275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "193 Asheville Hwy",
            "address_purpose": "LOCATION",
            "city": "Sylva",
            "state": "NC",
            "postal_code": "287792731",
            "country_code": "US",
            "telephone_number": "828-586-8935",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WENTZ",
        "first_name": "SHAIGNA",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "3002168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.