Katlyn Daniel Shaw, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

264355 Issued in KY

Practice address

23 W Center St FL 1
Madisonville, KY 42431-1941

Phone

(270) 452-2835

NPI assigned

Jul 3, 2021

Last updated

Jul 3, 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 1

Addresses

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

Locations

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.

• Bluegrass Kids Therapy Center LLC

  • Speech-Language Pathologist
  • Madisonville, KY
  • NPI 1043976152

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1625270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625270400000",
    "number": "1356912075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 GILL FIELD RD",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424319569",
            "telephone_number": "270-339-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 W CENTER ST FL 1",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311941",
            "telephone_number": "270-452-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KATLYN",
        "middle_name": "DANIEL",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-03",
        "last_updated": "2021-07-03",
        "certification_date": "2021-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "264355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Scott, NP-C
• Ronald James Segebarth, DDS
• Michael Wayne Seiber, R.PH.
• Seibert Chiropractic Center Inc.
• Paul Cyrus Shahidi, MD
• Laura Shaw
• Cameka Ann Shelby, LPCC
• Brandy M. Shelton
• Christina Rose Sherill
• Elizabeth Dawn Sherman, SLP

• Speech-Language Pathologist in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Speech-Language Pathologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.