Individual provider Active NPI

Gena Shatswell, MS CCC SLP

  • Speech-Language Pathologist
  • Altus, OK
National Provider Identifier
1851762637
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2987 Issued in OK
Practice address
401 W Tamarack Rd
Altus, OK 73521-1529
Phone
(580) 482-7308
Fax
(580) 477-2763
NPI assigned
Oct 19, 2015
Last updated
Apr 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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 2987 OK Primary

Addresses

Primary practice location

401 W Tamarack Rd
Altus, OK 73521-1529

Mailing address

401 W Tamarack Rd
Altus, OK 73521-1529
Phone (580) 482-7308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2987OKMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1445212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1851762637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W TAMARACK RD",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211529",
            "telephone_number": "580-482-7308",
            "fax_number": "580-477-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W TAMARACK RD",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735211529",
            "telephone_number": "580-482-7308",
            "fax_number": "580-477-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATSWELL",
        "first_name": "GENA",
        "credential": "MS CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-19",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "2987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altus, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; 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.