Shannon Marie Kelly, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

113034 Issued in TX

Practice address

900 Washington Ave Ste 602
Waco, TX 76701-1283

Phone

(254) 296-9792

NPI assigned

Oct 24, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tots in Tow, LLC

  dba Care Options for Kids

  • Home Health Agency
  • Austin, TX
  • NPI 1700286580
  NPD (past)

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679084172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WASHINGTON AVE STE 602",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WASHINGTON AVE STE 602",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011283",
            "telephone_number": "254-296-9792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4300 Sigma Rd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752444422",
            "country_code": "US",
            "telephone_number": "972-630-6369",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lance P Kelley, PH.D.
• Ashley Mechelle Kelly
• Jack Kelly, DMD
• Mendy Kelly, LCSW
• Samuel Kelly
• Dustin Dwain Kelm, PT, DPT
• Carol Ann Kemp, LCSW
• Karen Cervenka Kemper, MD
• Annika Kempf, MD
• Zachry Thomas Kempf, DO

• Speech-Language Pathologist in Waco, TX
• Providers in Waco, TX by specialty
• Speech-Language Pathologist in Texas

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