Carly Shackle

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP.14341 Issued in OH

Practice address

4880 Tuttle Rd
Dublin, OH 43017-7566

Phone

(614) 760-8870

NPI assigned

Mar 4, 2020

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

Enrolled in OH

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Healthpro Heritage Rehab & Fitness, LLC

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  • Bedford, OH
  • NPI 1689194755
  Medicare reassignment
• Mobile Medical, Inc.

  • Dentist
  • Perrysburg, OH
  • NPI 1629228572
  NPD (past)
• Spectrum Psychological Services, Inc

  • Clinical Psychologist
  • Columbus, OH
  • NPI 1245605864
  NPD (past)

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1720613318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3693 MOUNTSHANNON RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432215238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 TUTTLE RD",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430177566",
            "telephone_number": "614-760-8870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHACKLE",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-04",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.14341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seva Dental Ohio LLC
• Lisa Sexton
• Nicholas Sgobbo, LCSW
• Sharis C Shabandari, CNP
• Rabihah Shabazz
• Robert F Shadel, M.D.
• Kylie Nichole Shafer, COTA/L
• Angie Shaffer
• Destiny Shaffer
• Erin Shaffer

• Speech-Language Pathologist in Dublin, OH
• Providers in Dublin, OH by specialty
• Speech-Language Pathologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2026; 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.