Genea Deshields Deshields Boykin, MSP CCC SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3951 Issued in SC

Practice address

355 Ridge Run Trail
Irmo, SC 29063

Phone

(803) 271-2364

Fax

(803) 708-5618

NPI assigned

Jan 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Genea Olisha Deshields Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Palmetto Early Beginnings

  • Speech-Language Pathologist
  • Irmo, SC
  • NPI 1669766341
  NPD (past)

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1013193820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 RIDGE RUN TRAIL",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "803-271-2364",
            "fax_number": "803-708-5618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 RIDGE RUN TRAIL",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "29063",
            "telephone_number": "803-271-2364",
            "fax_number": "803-708-5618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESHIELDS BOYKIN",
        "first_name": "GENEA",
        "middle_name": "DESHIELDS",
        "name_prefix": "Mrs.",
        "credential": "MSP CCC SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "3951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GENEA",
            "last_name": "DESHIELDS",
            "middle_name": "OLISHA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael David Deason, LPC
• Seneca Decastro, OPTICIAN
• Deborah Mullins Dellinger, LPC
• Steven Denton, PTA
• Paul W Derrick, OD
• John Dickinson
• Heather Diebold, PHARMD
• Shannon Dill-Williams, MSW
• Joanne Dimirra
• Distinctive Dentistry

• Speech-Language Pathologist in Irmo, SC
• Providers in Irmo, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.