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Deactivated NPI 1740527100 Deactivated / Inactive NPI Female Practitioner

Dr. Jo Shackelford , EdD, CCC-SLP

Speech-Language Pathologist • Bowling Green, KY

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Jo Shackelford has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 04, 2013
NPI Deactivation Date April 16, 2018
Total Practice Duration ~32 Years of Practice (1986 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. Jo Shackelford, EdD, CCC-SLP was a registered Speech-Language Pathologist practicing in Bowling Green, KY. Throughout an active medical career spanning 32 years, Dr. Shackelford provided care at the practice location at 1918 MOSSWOOD DR until profile deactivation on 2018-04-16.

Dr. Shackelford was affiliated with University Of Massachusetts and did not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

1918 Mosswood Dr

Bowling Green, KY 421044550

Telephone 2702023316
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

1986

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Bowling Green, KY

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
40 Yrs +22.8 yrs vs City Avg
City Avg: 17.2 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
143 Specialists

Practicing in Bowling Green, KY (2945 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Shackelford (40 Years) 40 Yrs
Bowling Green Specialty Average (17.2 Years) 17.2 Yrs

Medical Specialties & State Licenses

CMS Verified: 2020-02-26
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License KY 1374

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.

Hospital & Practice Group Affiliations

University Of Massachusetts

358 N Pleasant St, Amherst, MA 010039296

Phone: 4135452565

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location February 26, 2020

Registered at 1918 MOSSWOOD DR, BOWLING GREEN, KY 421044550 (Tel: 2702023316)

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Updated Business Mailing Address February 26, 2020

Registered at 1133 CHESTNUT ST., #3, BOWLING GREEN, KY 42101 (Tel: 2702023316)

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Provider Name / Credentials Updated February 26, 2020

Recorded as JO SHACKELFORD, ED.D., CCC-SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 26, 2020

Speech-Language Pathologist (License #1374 in KY)

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NPI Profile Deactivated April 16, 2018

Record deactivated on April 16, 2018

NPI Profile Active April 16, 2014

NPI status registered as active in NPPES database

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Updated Practice Location April 16, 2014

Registered at 1918 MOSSWOOD DR, BOWLING GREEN, KY 421044550 (Tel: 2702023316)

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Updated Business Mailing Address April 16, 2014

Registered at 1918 MOSSWOOD DR, BOWLING GREEN, KY 421044550 (Tel: 2702023316)

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Provider Name / Credentials Updated April 16, 2014

Recorded as JO SHACKELFORD, ED.D., CCC-SLP

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 16, 2014

Speech-Language Pathologist (License #1374 in KY)

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Initial NPI Registration & Enumeration January 04, 2013

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740527100
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 04, 2013
Last Update: February 26, 2020
Deactivation Date: April 16, 2018
Sole Proprietor: No

Mailing Address

1133 Chestnut St., #3

Bowling Green, KY 42101

Phone: 2702023316

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.