Individual provider Active NPI

Laura Thornton Shores, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Germantown, TN
National Provider Identifier
1003042557
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP000003675 Issued in TN
Practice address
7901 Poplar Avenue
Germantown, TN 38138-6005
Phone
(901) 758-2228
Fax
(901) 531-6735
NPI assigned
Jun 10, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP000003675 TN Primary

Addresses

Primary practice location

7901 Poplar Avenue
Germantown, TN 38138-6005

Mailing address

7901 Poplar Avenue
Germantown, TN 38138-6005
Phone (901) 758-2228

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3675TNMDMental Health Counselor
SP000003675TNMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1003042557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 POPLAR AVENUE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381386005",
            "telephone_number": "901-758-2228",
            "fax_number": "901-531-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 POPLAR AVENUE",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381386005",
            "telephone_number": "901-758-2228",
            "fax_number": "901-531-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORES",
        "first_name": "LAURA",
        "middle_name": "THORNTON",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-10",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP000003675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.