Active NPI
Ellen Shutt
- Speech-Language Pathologist
- Abilene, TX
National Provider Identifier
1417196197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 104055
- Practice address
- 1 Village Dr
Suite 400
Abilene, TX 79606-8231 - Phone
- (325) 691-5519
- NPI assigned
- Feb 19, 2009
- Last updated
- Feb 19, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 104055 | TX | Primary |
Addresses
Primary practice location
1 Village Dr
Suite 400
Abilene, TX 79606-8231
Mailing address
1 Village Dr
Suite 400
Abilene, TX 79606-8231
Phone (325) 691-5519
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104055 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1235001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235001600000",
"number": "1417196197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 VILLAGE DR",
"address_2": "SUITE 400",
"city": "ABILENE",
"state": "TX",
"postal_code": "796068231",
"telephone_number": "325-691-5519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 VILLAGE DR",
"address_2": "SUITE 400",
"city": "ABILENE",
"state": "TX",
"postal_code": "796068231",
"telephone_number": "325-691-5519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHUTT",
"first_name": "ELLEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-19",
"last_updated": "2009-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "104055",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Abilene, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.