Crystal Dawn Shelley, M.A.CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4178 Issued in TN

Practice address

127 S Kentucky St
Kingston, TN 37763-2746

Phone

(865) 285-9411

NPI assigned

Jul 31, 2013

Last updated

Jul 31, 2013By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Elizabeth Jenkins

  • Speech-Language Pathologist
  • Kingston, TN
  • NPI 1194158204
  NPD (past)
• HHC, LLC

  dba Amedisys Home Health Care

  • Home Health Agency
  • Cordova, TN
  • NPI 1134177983
  NPD (past)
• Speech Pathology Associates

  • Hearing and Speech Clinic/Center
  • Kingston, TN
  • NPI 1629426143
  NPD (past)

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375228800000",
    "number": "1306278312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WINDING TRL",
            "city": "HARRIMAN",
            "state": "TN",
            "postal_code": "377484955",
            "telephone_number": "865-466-1493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 S KENTUCKY ST",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377632746",
            "telephone_number": "865-285-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELLEY",
        "first_name": "CRYSTAL",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2013-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "4178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelynn Marie Rutkowski, NCC
• Susan Sain, OT
• David John Schneider, PHARMD
• Karie Elise Scott, OTR
• Sequel Schools LLC Dba Kingston Academy
• Eden Buchanan Sherrod, PT, DPT
• Travis Wayne Sisco, DDS
• Kaybe Michelle Slaven, PHARM.D.
• Sleep Soundly TN PLLC
• Moriah Camak Smith, MSP CCC-SLP

• Speech-Language Pathologist in Kingston, TN
• Providers in Kingston, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.