Shannon Hanley Kedzior, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL008524 Issued in PA

Practice address

160 E Erie Ave
Philadelphia, PA 19134-1011

Phone

(215) 427-5487

NPI assigned

Feb 6, 2023

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

Other names 1

• Miss Shannon Lynne Hanley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1558067033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13579",
            "city": "READING",
            "state": "PA",
            "postal_code": "196123579",
            "telephone_number": "484-628-1324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 E ERIE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191341011",
            "telephone_number": "215-427-5487"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 York Rd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "190462852",
            "country_code": "US",
            "telephone_number": "267-981-6330",
            "fax_number": "215-885-2123",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEDZIOR",
        "first_name": "SHANNON",
        "middle_name": "HANLEY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-06",
        "last_updated": "2024-05-22",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL008524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "HANLEY",
            "middle_name": "LYNNE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Keating, LPC
• Linda Kebichi
• Matthew R. Kebler, PHARMD
• Amer M Kechli, MD
• Mei-Le Keck
• Kathleen Kedziora, CRNA
• Nicole Marie Kedziora
• Shanera Kee
• Michael C Keebler
• Robert Shawn Keebler, MD

• Speech-Language Pathologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.