Individual provider Active NPI

Shawna M Katkavich

  • Audiologist
  • Spartanburg, SC
National Provider Identifier
1932792124
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4167 Issued in SC
Practice address
104 Franklin Ave Ste C
Spartanburg, SC 29301-2596
Phone
(864) 574-4064
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4167 SC Primary

Addresses

Primary practice location

104 Franklin Ave Ste C
Spartanburg, SC 29301-2596

Mailing address

716 Augusta St Apt B
Greenville, SC 29605-3874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240816003378 MA Practitioner - Qualified Audiologist 5395150387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Associates in Otolaryngology Head and Neck Surgery, PCGroup PAC ID 6507839438, 9 clinicians

Practice addresses (Care Compare)

100 MLK Jr Blvd
Suite 4
Worcester, MA 01608-1209
Phone (508) 757-0330

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4167SCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Otolaryngology Head and Neck Surgery PC CurrentSince Jun 9, 2024 Accepting new patients

Locations

100 Mlk Jr Blvd
Worcester, MA 01608
Phone (508) 754-3823

48 Elm St
Worcester, MA 01609
Phone (508) 757-0330

100 Mlk Jr Blvd
Ste 4
Worcester, MA 01608
Phone (508) 757-0330

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1932792124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 AUGUSTA ST APT B",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296053874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FRANKLIN AVE STE C",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293012596",
            "telephone_number": "864-574-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATKAVICH",
        "first_name": "SHAWNA",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "SC",
            "license": "4167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.