Basic Information
Provider Information
NPI: 1275172389
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINETTE
FirstName: CLAUDIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 90 HOWARD DR
Address2:  
City: SHELBYVILLE
State: KY
PostalCode: 400658138
CountryCode: US
TelephoneNumber: 5026331007
FaxNumber: 5028051511
Practice Location
Address1: 100 RIVER RD
Address2:  
City: LOUDON
State: TN
PostalCode: 377741042
CountryCode: US
TelephoneNumber: 6156148833
FaxNumber: 6156148811
Other Information
ProviderEnumerationDate: 01/06/2020
LastUpdateDate: 07/29/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/29/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X6694TNY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

ID Information
IDTypeStateIssuerDescription
Q05467205TN MEDICAID


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