Individual provider Active NPI

Kathryne Gayle Shillings, SPEECH LANGUAGE PATH

  • Speech-Language Pathologist
  • Sweetwater, TX
National Provider Identifier
1609606037
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
121715 Issued in TX
Practice address
1104 Henderson St
Sweetwater, TX 79556-6450
Phone
(325) 236-6821
Fax
(432) 298-9897
NPI assigned
Aug 1, 2024
Last updated
Aug 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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 121715 TX Primary

Addresses

Primary practice location

1104 Henderson St
Sweetwater, TX 79556-6450

Mailing address

1104 Henderson St
Sweetwater, TX 79556-6450
Phone (325) 236-6821

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250929002348 TX Practitioner - Qualified Speech Language Pathologist 6204332323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4010 Medical Park Dr
Odessa, TX 79765-2233

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Therapy of Texas Speech-Language Pathologist CurrentSince Sep 2, 2025 Accepting new patients
Tanya Manriquez Lujan M.S., CCC-SLP, PLLC Speech-Language Pathologist CurrentSince Sep 2, 2025 Accepting new patients
West Texas Centers for MHMR PastSince Aug 4, 2024 Accepting new patients

Locations

4010 Medical Park Dr
Odessa, TX 79765
Phone (432) 614-0268

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1609606037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 HENDERSON ST",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795566450",
            "telephone_number": "325-236-6821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 HENDERSON ST",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795566450",
            "telephone_number": "325-236-6821",
            "fax_number": "432-298-9897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHILLINGS",
        "first_name": "KATHRYNE",
        "middle_name": "GAYLE",
        "credential": "SPEECH LANGUAGE PATH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "121715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sweetwater, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.