Catherine Matlock-Shally

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

OM000221 Issued in PA

Practice address

437 Crescent Rd
Wyncote, PA 19095-1717

Phone

(267) 241-4321

NPI assigned

Jun 21, 2018

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

• Kate Shally Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Six Fishes Acupuncture

  • Acupuncturist
  • Philadelphia, PA
  • NPI 1275081648
  NPD (past)

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

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529539200000",
    "number": "1629562707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "437 CRESCENT RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951717",
            "telephone_number": "267-241-4321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 CRESCENT RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951717",
            "telephone_number": "267-241-4321"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2308 Grays Ferry Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191461177",
            "country_code": "US",
            "telephone_number": "215-772-1040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATLOCK-SHALLY",
        "first_name": "CATHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "PA",
            "license": "OM000221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATE",
            "last_name": "SHALLY",
            "credential": "LOM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Donald Liss, MD
• Lauren Lynch, PHARMD
• Sarah Catherine Maheady, PHARMD
• Bryan Margerum, MD
• Stephen H Margolis, MD
• Pamela Denise McClenton, LCSW
• Latonya McCurry, MA, LPC, NCC
• Nicole McDonnell
• Jessica May McGuth
• Shawn Jude McIlvain, CRNP

• Acupuncturist in Wyncote, PA
• Providers in Wyncote, PA by specialty
• Acupuncturist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.