Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1053044537 Individual Practitioner Female Practitioner

Shannon Waller

Speech-Language Pathologist • Grand Rapids, MI

Professional Overview & Biography Verified Profile Summary

Shannon Waller is a registered healthcare professional specializing in Speech-Language Pathologist in Grand Rapids, MI. Practice services are available at 235 WEALTHY ST SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

235 Wealthy St Se

Grand Rapids, MI 495035247

Telephone 8005288989
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Grand Rapids, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.6 Yrs
State Avg: 12.5 Yrs
Regional Practice Density
281 Specialists

Practicing in Grand Rapids, MI (3778 Statewide)

Telehealth Adoption Rate
0.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-01
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

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.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License MI 7101001306

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Lara (Michigan)
7101001306 (MI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners
Mackenzie Morris

Occupational Therapist

NPI 1164202834
Dr. Rachel Madsen , DPT

Physical Therapist

NPI 1396520920

Doctor of Physical Therapy

Emily Lundeen

Occupational Therapist

NPI 1437965993
Kasey Bowman , OTRL

Occupational Therapist

NPI 1629930813

Occupational Therapist Registered & Licensed

Marissa Korodan

Speech-Language Pathologist

NPI 1659843795

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active July 02, 2022

NPI status registered as active in NPPES database

📍
Updated Practice Location July 02, 2022

Registered at 235 WEALTHY ST SE, GRAND RAPIDS, MI 495035247 (Tel: 8005288989)

📍
Updated Business Mailing Address July 02, 2022

Registered at 235 WEALTHY ST SE, GRAND RAPIDS, MI 495035247 (Tel: 6168408000)

👤
Provider Name / Credentials Updated July 02, 2022

Recorded as SHANNON WALLER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2022

Speech-Language Pathologist (License #7101001306 in MI)

🟢
Initial NPI Registration & Enumeration July 02, 2022

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Shannon Waller. Be the first to share your experience!

Sign in to leave a review for Shannon Waller

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1053044537
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 02, 2022
Last Update: July 02, 2022
Sole Proprietor: No

Mailing Address

235 Wealthy St Se

Grand Rapids, MI 495035247

Phone: 6168408000

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.