Active NPI
Shannon E Butkus, CCC-SLP
- Speech-Language Pathologist
- The Woodlands, TX
National Provider Identifier
1528071081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19362
- Practice address
- 18 N Timber Top Dr
The Woodlands, TX 77380-1445 - Phone
- (713) 614-1876
- Fax
- (713) 222-2678
- NPI assigned
- Aug 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 19362 | TX | Primary |
Addresses
Primary practice location
18 N Timber Top Dr
The Woodlands, TX 77380-1445
Mailing address
18 N Timber Top Dr
The Woodlands, TX 77380-1445
Phone (713) 614-1876
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 179859701 | Medicaid | TX | |
| 179859702 | Medicaid | TX |
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 |
|---|---|---|---|
| 19362 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1528071081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 N TIMBER TOP DR",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773801445",
"telephone_number": "713-614-1876",
"fax_number": "713-222-2678"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18 N TIMBER TOP DR",
"city": "THE WOODLANDS",
"state": "TX",
"postal_code": "773801445",
"telephone_number": "713-614-1876",
"fax_number": "713-222-2678"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTKUS",
"first_name": "SHANNON",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "CCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-15",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "19362",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "179859701",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "179859702",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in The Woodlands, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.