Shelley Landry

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

113485 Issued in TX

Practice address

500 South St Ste 300
Vidor, TX 77662-6183

Phone

(409) 498-4066

NPI assigned

Apr 25, 2017

Last updated

Aug 14, 2019By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids Therapy Set, LLC

  • Multi-Specialty Clinic/Center
  • Vidor, TX
  • NPI 1194073353

  Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1493078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1992230148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 NE LOOP 820",
            "address_2": "BUSINESS TOWER 1, SUITE 200",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760537209",
            "telephone_number": "817-292-8787",
            "fax_number": "817-789-6849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SOUTH ST STE 300",
            "city": "VIDOR",
            "state": "TX",
            "postal_code": "776626183",
            "telephone_number": "409-498-4066"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "87 Interstate 10 N",
            "address_2": "Suite 225",
            "address_purpose": "LOCATION",
            "city": "Beaumont",
            "state": "TX",
            "postal_code": "777072544",
            "country_code": "US",
            "telephone_number": "409-835-0228",
            "fax_number": "409-835-0151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "SHELLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-25",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matilda Denise Kelley, BSN, RN, CLT
• Kelley's Karing Touch, LLC (Karing Touch - Complete Lymphatic Decongestive Therapy)
• Kids Therapy Set, LLC
• Melvin Kohn
• Jennie Lam, PHARMD
• Jerry Dwayne Leavins, DDS
• Morgan Nicole Lewallen, M.S. CCC-SLP
• Liberty County Hospital District No. 1 (Vidor Health & Rehabilitation Center)
• Taryn Danee Light, SPEECH-LANGUAGE PATH
• Barbara Chyenne Loftin

• Speech-Language Pathologist in Vidor, TX
• Providers in Vidor, 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 Aug 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.