Kaitlyn Rose Shoults, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10291 Issued in MN

Practice address

10273 Yellow Circle Dr
Minnetonka, MN 55343-9144

Phone

(952) 401-9359

NPI assigned

Jan 19, 2021

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 MN

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Holland CenterGroup PAC ID 1759507882, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Holland Center

  • Developmentally Disabled Services Day Training Agency
  • Minnetonka, MN
  • NPI 1467641555
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728432000000",
    "number": "1982294443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 PIERCE ST NE APT 1",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554132742",
            "telephone_number": "701-400-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10273 YELLOW CIRCLE DR",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439144",
            "telephone_number": "952-401-9359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOULTS",
        "first_name": "KAITLYN",
        "middle_name": "ROSE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace A Shirley, ARNP
• Elliot Shively
• Stephanie Lynne Shively, PH.D., M.A.
• Cassandara M Shockley, APRN, BC
• Nichole Short
• Brian Shragg, D.D.S
• Shree Revenue Management
• Emily Shultz
• Alesya Shumkov, FNP-BC
• Thomas Dale Shypulski

• Speech-Language Pathologist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.