Janice Victoria Shook, M.S.,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S0575 Issued in MS

Practice address

119 Olson Ave
Long Beach, MS 39560-5825

Phone

(228) 860-4407

NPI assigned

Jan 12, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263254400000",
    "number": "1124358379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 OLSON AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395605825",
            "telephone_number": "228-860-4407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 OLSON AVE",
            "city": "LONG BEACH",
            "state": "MS",
            "postal_code": "395605825",
            "telephone_number": "228-860-4407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOK",
        "first_name": "JANICE",
        "middle_name": "VICTORIA",
        "credential": "M.S.,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S0575",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP001495",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Long Beach, MS
• Providers in Long Beach, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.