MRS. SHANA K CONNELLY (MASTERS SLP) – Speech-Language Pathologist, NPI 1275727760

MRS. SHANA K CONNELLY (MASTERS SLP) is a healthcare provider. based in Brunswick, Ohio. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. They hold the professional credentials MASTERS SLP. They hold a License No. SP8602 (OH). The NPI Number for MRS. SHANA K CONNELLY (MASTERS SLP) is 1275727760

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
MRS. SHANA K CONNELLY (MASTERS SLP)
NPI
1275727760
Phone
(330) 220-8266
Address
4076 DENNIS LN
Enumeration Date
28 August 2007
Last Update Date
25 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9373450969
Graduation Year
2004 (22 years ago)
PAC ID
7911428511
Group Practice PAC ID
2365718277
Professional Enrollment ID
I20250312001323
Address ID
OH450661293SP355XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

312 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in OH

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Provider Addresses for MRS. SHANA K CONNELLY (MASTERS SLP)

  • 4076, Dennis Lane, Brunswick, Medina County, Ohio, 44212, United States

    BRUNSWICK, OH 442122904

    Phone: (330) 220-8266

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250312001323IQualified Speech Language PathologistOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 44212)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2365718277View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
-IL
Physical Therapist In Private PracticeNY
-MO
Qualified Speech Language PathologistIL
Qualified Speech Language PathologistIN
Physical Therapist In Private PracticeMI
Qualified Speech Language PathologistIN
-IL

Reviews

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Frequently asked questions

What unique ID ties claims to MRS. SHANA K CONNELLY (MASTERS SLP)?
NPI 1275727760 is assigned to MRS. SHANA K CONNELLY (MASTERS SLP) under the national enumeration system.
Is MRS. SHANA K CONNELLY (MASTERS SLP)'s NPI currently valid?
The extract we use shows MRS. SHANA K CONNELLY (MASTERS SLP) as active.
Does MRS. SHANA K CONNELLY (MASTERS SLP) list a primary specialty?
If you are matching referrals, note Speech-Language Pathologist for MRS. SHANA K CONNELLY (MASTERS SLP). Clinical services aligned with this taxonomy classification.
Where does public data place MRS. SHANA K CONNELLY (MASTERS SLP)?
The snapshot lists Brunswick, Ohio for MRS. SHANA K CONNELLY (MASTERS SLP); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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