Shannon Kristina Slate, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2-0511 Issued in AL

Practice address

5275 Millennium Dr NW
Huntsville, AL 35806-2457

Phone

(256) 489-6800

NPI assigned

Sep 24, 2012

Last updated

Sep 24, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1033460605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 PARKER RD SE",
            "city": "HARTSELLE",
            "state": "AL",
            "postal_code": "356403364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5275 MILLENNIUM DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358062457",
            "telephone_number": "256-489-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLATE",
        "first_name": "SHANNON",
        "middle_name": "KRISTINA",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "2-0511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sixfourthree, LLC (Fairhope Physical Therapy Services)
• Daniel Edward Skinner III, M.D.
• Wendy Gail Skinner, CRNP
• Audrey Jill Skipworth
• Charles Slagle, NP
• Danielle A Slaten, CRNA
• Summer Paige Slater, CRNP
• John Stuart Slaven, MD
• Carlquista Champagne Slay, LPC
• Brittany Jenique Sledge-Drake

• Physical Therapy Assistant in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Physical Therapy Assistant in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2012; 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.