SHELBY WAGNER M.S., CCC-SLP
NPI 1760976450
Speech-Language Pathologist in Kenosha, WI

Q: What is Shelby Wagner's NPI number?

The NPI number for Shelby Wagner is 1760976450. It was assigned to this individual provider in the NPPES registry on June 18, 2018.

Q: What is Shelby Wagner's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Shelby Wagner was last updated on May 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 18, 2018

5219 88TH AVE, KENOSHA, WI 53144(262) 653-0850 Get Directions Write a Review

NPPES record last updated: May 19, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 19, 2026, Jun 18, 2018 (2 updates tracked since 2018).

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About Shelby Wagner M.s., Ccc-slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHELBY WAGNER M.S., CCC-SLP (NPI 1760976450) is an individual speech-language pathologist provider in Kenosha, Wisconsin, licensed in Texas (121280) and active in the NPI registry since June 2018. She is a graduate of Other (2018).

NPPES Registry Identity

NPI1760976450

Entity TypeIndividualFemale

Primary Taxonomy235Z00000X

Provider Legal NameSHELBY WAGNERCredential: M.S., CCC-SLP

Location Address5219 88TH AVEKenosha, WI 53144-7468

Mailing Address5219 88th AveKenosha, WI 53144-7468

Phone(262) 653-0850

Sole ProprietorNo

Medical School CMSOtherGraduated 2018

Enumeration DateJune 18, 2018

Last NPPES UpdateMay 19, 20262 updates tracked since enumeration

NPPES CertifiedMay 19, 2026

✔ NPI 1760976450 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers

Taxonomy Code235Z00000X

Licenses✔ Licensed in TX · 121280✔ Licensed in WI · 4646-154

Definition

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.

5219 88TH AVE, Kenosha, WI 53144

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shelby Wagner M.s., Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8628548930

PECOS Enrollment IDI20260602003010

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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