Kelly Shaw, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3456-154 Issued in WI

Practice address

5219 88TH Ave
Kenosha, WI 53144-7468

Phone

(262) 653-0850

NPI assigned

Jul 3, 2012

Last updated

Jul 3, 2012By 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

Credentials

Master of Science

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.

• Tender Touch Therapy LLC

  • Physical Therapist
  • Kenosha, WI
  • NPI 1518026533

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1790049807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14460 W HONEY LN",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531512314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5219 88TH AVE",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531447468",
            "telephone_number": "262-653-0850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "KELLY",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "3456-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elika Anne Shapiro, LCSW
• James A Shapiro, MD
• Randa Ahmed Sharag Eldin, MD
• Umair Sharih
• Venkata Krishna Sharma, MD
• Joanne Sheen
• Shellie K Babcock, LCSW LLC
• Alison Amalia Shelton, FNP-BC
• Tori Shelton, LPC-IT
• Neil A Shepler, MD

• Speech-Language Pathologist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Speech-Language Pathologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.