Shirley Jane Goetze, CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

17553 Issued in TX

Practice address

1200 Dudley Rd
Kilgore, TX 75662-3306

Phone

(903) 984-5571

NPI assigned

Sep 24, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• East Texas Treatment Center

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Kilgore, TX
  • NPI 1023002425
  NPD (past)

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

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1962710962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15693 COUNTY ROAD 373",
            "city": "GLADEWATER",
            "state": "TX",
            "postal_code": "756479160",
            "telephone_number": "903-877-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 DUDLEY RD",
            "city": "KILGORE",
            "state": "TX",
            "postal_code": "756623306",
            "telephone_number": "903-984-5571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOETZE",
        "first_name": "SHIRLEY",
        "middle_name": "JANE",
        "name_prefix": "Mrs.",
        "credential": "CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-24",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "17553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPEECH, LANGUAGE PATHOLOGY LICENSE",
            "identifier": "17553",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Darlene Franks, BSN RN
• La Tamera D Fry, LAT
• Darrell Layne Ganus, MED, LAT, ATC
• Michael Gardner, D.D.S.
• Get to the Point Wellness PLLC
• Hailey Goza
• Paul A Grant Jr, MD
• Grant-Moore Center for Behavioral Health, Inc.
• Christopher Richard Gratton, D.C., P.C.
• Gloria Salazar Gray, RN, FNP-C

• Speech-Language Pathologist in Kilgore, TX
• Providers in Kilgore, 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 Sep 24, 2010; 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.