Shelby Wagner, M.S., CCC-SLP
NPI 1760976450ActiveIndividual· Speech-Language Pathologist· Kenosha, WI
Speech-Language Pathologist (M.S., CCC-SLP) in Kenosha, Wisconsin, licensed in TX and WI, with an NPI issued in June 2018. Enrolled in Medicare as practitioner - qualified speech language pathologist and practitioner - qualified speech language pathologist.
Overview
| NPI | 1760976450 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.S., CCC-SLP |
| Sole proprietor | No |
| NPI issued | Jun 18, 2018 |
| Last updated in NPPES | May 19, 2026 |
| Certified by provider | May 19, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 121280 | TX |
| Speech-Language Pathologist | 235Z00000X | 4646-154 | WI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Speech Language Pathologist (TX); Practitioner - Qualified Speech Language Pathologist (WI) |
|---|
Education and affiliations
| Graduation year | 2018 |
|---|---|
| Medicare specialty | Qualified Speech Language Pathologist |
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