Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1902006448 Individual Practitioner Female Practitioner

Shannon Pauline Gregory , MS, CCC-SLP

Speech-Language Pathologist • Watertown, NY

Professional Overview & Biography Verified Profile Summary

Shannon Gregory, MS, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Watertown, NY. Practice services are available at 20104 NYS RT 3 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

20104 Nys Rt 3

Watertown, NY 136015560

Telephone 3157772659

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Watertown, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.0 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
51 Specialists

Practicing in Watertown, NY (25106 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

Medical Specialties & State Licenses

CMS Verified: 2025-06-27
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License NY 013829-1

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 NC 6090

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

Medicaid State Provider ID
7412311 (NC)

Practice Associates & Co-Workers

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

15 Associated Practitioners
Jaclyn Lane

Occupational Therapist

NPI 1063797926
NPI 1164791596

Physical Therapist, Doctor of Physical Therapy, Certified Athletic Trainer, Certified Strength and Conditioning Specialist

NPI 1225453947

Master of Science

Denean Clark , RN

Registered Nurse - School

NPI 1396012621

Registered Nurse

Helene Murdock , OTR, L

Occupational Therapist - Pediatrics

NPI 1477822252

Occupational Therapist Registered, L

Kaitlyn Lehnhardt , MS

Speech-Language Pathologist

NPI 1558815571

Master of Science

Career & Practice History Timeline

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

13 Historical Events
📍
Updated Practice Location June 27, 2025

Registered at 20104 NYS RT 3, WATERTOWN, NY 136015560 (Tel: 3157772659)

📍
Updated Business Mailing Address June 27, 2025

Registered at 20104 NYS RT 3, WATERTOWN, NY 136015560 (Tel: 3157772659)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2025

Speech-Language Pathologist (License #6090 in NC)

📍
Updated Practice Location December 03, 2019

Registered at 124 MONROE AVE, WATERTOWN, NY 136013021 (Tel: 3157772659)

📍
Updated Business Mailing Address December 03, 2019

Registered at 124 MONROE AVE, WATERTOWN, NY 136013021 (Tel: 3157772659)

👤
Provider Name / Credentials Updated December 03, 2019

Recorded as SHANNON GREGORY, MS, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 03, 2019

Speech-Language Pathologist (License #013829-1 in NY)

NPI Profile Active July 23, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 23, 2007

Registered at 350 GOLDEN ROD LN, LEXINGTON, NC 272956889 (Tel: 3369560535)

📍
Updated Business Mailing Address July 23, 2007

Registered at 350 GOLDEN ROD LN, LEXINGTON, NC 272956889 (Tel: 3369560535)

👤
Provider Name / Credentials Updated July 23, 2007

Recorded as SHANNON BAKA, MS, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 23, 2007

Speech-Language Pathologist (License #6090 in NC)

🟢
Initial NPI Registration & Enumeration July 23, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1902006448
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 23, 2007
Last Update: June 27, 2025
Sole Proprietor: No

Mailing Address

20104 Nys Rt 3

Watertown, NY 136015560

Phone: 3157772659

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.