Active NPI
Shea Carnes, M.S., CCC-SLP
- Speech-Language Pathologist
- Prescott, AZ
National Provider Identifier
1003422601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- TSLP12504
- Practice address
- 300 E Gurley St
Prescott, AZ 86301-3823 - Phone
- (928) 717-3236
- NPI assigned
- Sep 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | TSLP12504 | AZ | Primary |
Addresses
Primary practice location
300 E Gurley St
Prescott, AZ 86301-3823
Mailing address
202 San Carlos Rd
Prescott, AZ 86303-3741
Phone (928) 830-9973
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)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TSLP12504 | AZ | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1677110400000",
"number": "1003422601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 SAN CARLOS RD",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863033741",
"telephone_number": "928-830-9973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E GURLEY ST",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863013823",
"telephone_number": "928-717-3236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARNES",
"first_name": "SHEA",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-18",
"last_updated": "2023-02-23",
"certification_date": "2023-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "TSLP12504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prescott, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.