Kayla Shackleford, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7544 Issued in TN

Practice address

514 S Brown St
Springfield, TN 37172-2937

Phone

(615) 988-4552

Fax

(615) 382-0501

NPI assigned

Jun 17, 2022

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 1

Other names 1

• Kayla Morris Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• RWW Outpatient Rehab Services, LLC

  • Physical Therapist
  • Hendersonville, TN
  • NPI 1770148793
  Medicare reassignment NPD
• RWW Outpatient Rehab Services, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1447744461
  NPD
• Shine Pediatric Therapy

  • Occupational Therapist
  • Springfield, TN
  • NPI 1891041133
  NPD (past)
• Sumner County Board of Education

  • Local Education Agency (LEA)
  • Gallatin, TN
  • NPI 1912266206

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1356072771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1637",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371721637",
            "telephone_number": "615-988-4552",
            "fax_number": "615-382-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S BROWN ST",
            "city": "SPRINGFIELD",
            "state": "TN",
            "postal_code": "371722937",
            "telephone_number": "615-988-4552",
            "fax_number": "615-382-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLEFORD",
        "first_name": "KAYLA",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF TN LICENSE",
            "identifier": "7544",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Springfield",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "514 S Brown St",
            "city": "Springfield",
            "state": "TN",
            "country_code": "US",
            "postal_code": "371722937",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAYLA",
            "last_name": "MORRIS",
            "credential": "MS, CF-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Michael Sinclair Segerson, COTA/L
• Cassidy Ann Seiler, PA-C
• Alejandra Serrano, SLP-CCC
• Sharp Spine Center, LLC
• Brian Lane Sharp, D.C.
• Jennifer Sharp, MS-CCC, SLP
• Robert Allen Shearer, MD
• Marlon Lavell Shell, M.D.

• Speech-Language Pathologist in Springfield, TN
• Providers in Springfield, 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 Jun 17, 2022; 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.