KELLY SHAW (NPI# 1790049807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790049807 |
| Entity Type | Individual |
| Full Name | KELLY SHAW |
| Credential | MS CCC-SLP |
| Practice Address |
5219 88th Ave Kenosha WI 53144-7468 |
| Mailing Address |
14460 W Honey Ln New Berlin WI 53151-2314 |
| Practice Telephone | 2626530850 |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 3456-154 | WI | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762822 | Kelly Shaw | Student in an Organized Health Care Education/Training Program | 9800 Warwickshire Ln, Charlotte, NC 28270-1601 | 2020-05-19 |
| 1114113214 | Kelly L Shaw | Registered Nurse | 8154 Painted Tree Trl, Fort Worth, TX 76131-4559 | 2007-09-21 |
| 1801928924 | Kelly P Shaw | Dentist | 75-5995 Kuakini Hwy Ste 113, Kailua Kona, HI 96740-2120 | 2007-03-12 |
| 1780231100 | Kelly Grace Shaw | Behavior Technician | 565 Benfield Rd Ste 300, Severna Park, MD 21146-2517 | 2019-08-21 |
| 1700277852 | Kelly Shaw | Registered Nurse | 5901 E 7th St, Long Beach, CA 90822-5201 | 2015-02-11 |
| 1205226107 | Kelly Corey Shaw | Acupuncturist | 6018 Se Stark St, Portland, OR 97215-1990 | 2015-01-29 |
| 1720213358 | Kelly Shaw | Social Worker | 1001 Georges Station Rd, Greensburg, PA 15601-6982 | 2009-05-27 |
| 1740431915 | Kelly Shaw | Physical Therapist | 200 2nd Ave, Kingston, PA 18704-5722 | 2008-10-07 |
| 1376723874 | Kelly Anne Shaw | Counselor | 200 Heritage Way, Kalispell, MT 59901-3146 | 2007-11-13 |
| 1235255829 | Kelly Shaw | Occupational Therapy Assistant | 19401 S Vermont Ave, Suite A-200, Torrance, CA 90502-1029 | 2007-03-22 |
| Street Address |
5219 88TH AVE |
| City | KENOSHA |
| State | WI |
| Zip Code | 53144-7468 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225103591 | Jennifer Jilliann James | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2006-11-22 |
| 1548861859 | Emma R Hill | Physical Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2020-11-03 |
| 1437771821 | Nicole Movick | Physical Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2020-05-08 |
| 1275154742 | Abbey Elizabeth Brown | Occupational Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2020-05-06 |
| 1154970374 | Sophia Polaris | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2019-09-10 |
| 1386292308 | Nathan James Croatt | Occupational Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2019-09-03 |
| 1538712799 | Carly Weber | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2019-07-17 |
| 1649736760 | Ericka Rehrer | Occupational Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2019-02-13 |
| 1487133211 | Madison Damaschke | Occupational Therapist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2018-08-13 |
| 1760976450 | Shelby Wagner | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2018-06-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410202 | Dpt Holdings LLC | Occupational Therapist | 3825 39th Ave #110, Kenosha, WI 53144 | 2020-09-03 |
| 1225641392 | Eunice Boatin | Social Worker | Kenosha Human Development Services, 3536 52nd Street, Kenosha, WI 53144 | 2020-08-28 |
| 1881250256 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3621 Market Lane, Kenosha, WI 53144 | 2019-05-11 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1174992721 | Claire Ann Adams | Acupuncturist | 5416 52nd Street, Kenosha, WI 53144 | 2015-09-24 |
| 1285017087 | Jessica Lynn Gillengerten | Acupuncturist | 4235 Green Bay Rd., Suite #10, Kenosha, WI 53144 | 2015-06-30 |
| 1750704656 | Amanda Kay Kreuzer | Occupational Therapy Assistant | 3109 30th Ave, Kenosha, WI 53144 | 2014-01-28 |
| 1841626785 | B7 Pharmacy Inc | Pharmacy | 3825 39th Ave Ste 100, Kenosha, WI 53144 | 2013-09-24 |
| 1124326764 | Wisconsin Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3710 57th Ave, Kenosha, WI 53144 | 2011-03-07 |
| 1982931291 | Roman Bilak | General Practice | 4126 - 7th Street, Kemosha, WI 53144 | 2009-11-06 |
| Find all providers in zip 53144 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629686514 | Dana Handrow | Speech-Language Pathologist | 5507 28th St, Kenosha, WI 53144-4294 | 2020-07-16 |
| 1558873240 | Simply Spoken Therapy LLC | Speech-Language Pathologist | 7520 39th Ave # Ll9, Kenosha, WI 53142-4348 | 2017-11-02 |
| 1124540067 | Kaitlyn King | Speech-Language Pathologist | 5219 88th Ave., Kenosha, WI 53144 | 2017-07-12 |
| 1881133981 | Amanda Townsend | Speech-Language Pathologist | 2120 37th St, Kenosha, WI 53140-2350 | 2017-02-22 |
| 1225416977 | Kristen Weder | Speech-Language Pathologist | 7405 30th Ave, Kenosha, WI 53142-4403 | 2015-05-14 |
| 1275817298 | Angela Kongshaug | Speech-Language Pathologist | 4102 Washington Rd, Apt. 110, Kenosha, WI 53144-1522 | 2011-10-10 |
| 1003194895 | Auburn Lea Andes | Speech-Language Pathologist | 6300 67th St, Kenosha, WI 53142-1437 | 2011-07-27 |
| 1871726828 | Ashley Marie Anzalone | Speech-Language Pathologist | 8400 Sheridan Rd., Sheridan Medical Complex, Kenosha, WI 53143-6327 | 2009-08-25 |
| 1871767442 | Lisa Marie Conklyn | Speech-Language Pathologist | 5722 35th Ave, Kenosha, WI 53144-4124 | 2008-04-15 |
| 1225103591 | Jennifer Jilliann James | Speech-Language Pathologist | 5219 88th Ave, Kenosha, WI 53144-7468 | 2006-11-22 |
| Find all providers in KENOSHA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.