Individual provider Active NPI

Shannon Marie Kahn

  • Speech-Language Pathologist
  • Indianapolis, IN
National Provider Identifier
1417540873
Registry record updated Feb 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1119 E 56TH St
Indianapolis, IN 46220-3221
Phone
(317) 694-4195
NPI assigned
Feb 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2021

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 Primary

Addresses

Primary practice location

1119 E 56TH St
Indianapolis, IN 46220-3221

Mailing address

1119 E 56TH St
Indianapolis, IN 46220-3221
Phone (317) 694-4195

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL smkahn4@gmail.com

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

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613520000000",
    "number": "1417540873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203221",
            "telephone_number": "317-694-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 E 56TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462203221",
            "telephone_number": "317-694-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "smkahn4@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Work Email",
            "address_1": "1119 E 56th St",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462203221",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 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.