Individual provider Active NPI

Denise Shidal Gilbert, MS,SLP

  • Speech-Language Pathologist
  • Paducah, KY
National Provider Identifier
1396969523
Registry record updated May 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
0663 Issued in KY
Practice address
210 Audubon Dr
Paducah, KY 42001-4846
Phone
(270) 556-3684
Fax
(270) 210-2886
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2020

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 0663 KY Primary

Addresses

Primary practice location

210 Audubon Dr
Paducah, KY 42001-4846

Mailing address

210 Audubon Dr
Paducah, KY 42001-4846
Phone (270) 556-3684

Other practice location 1

9435 Walter Defreitas Drive
West Paducah, KY 42086
Phone (270) 554-0840

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0663KYMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588464000000",
    "number": "1396969523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 AUDUBON DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014846",
            "telephone_number": "270-556-3684",
            "fax_number": "270-201-2886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 AUDUBON DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420014846",
            "telephone_number": "270-556-3684",
            "fax_number": "270-210-2886"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9435 Walter Defreitas Drive",
            "address_purpose": "LOCATION",
            "city": "West Paducah",
            "state": "KY",
            "postal_code": "42086",
            "country_code": "US",
            "telephone_number": "270-554-0840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILBERT",
        "first_name": "DENISE",
        "middle_name": "SHIDAL",
        "name_prefix": "Mrs.",
        "credential": "MS,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-05-03",
        "certification_date": "2020-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "0663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2020; 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.