Active NPI
Shantice Toles
- Physical Therapy Assistant
- Summit, MS
National Provider Identifier
1174763221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4045
- Practice address
- 4109 Hwy 98 West
Summit, MS 39666 - Phone
- (601) 276-3900
- NPI assigned
- Mar 3, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4045 | AL | Primary |
Addresses
Primary practice location
4109 Hwy 98 West
Summit, MS 39666
Mailing address
810 Chattie James Dr
Tuskegee, AL 36083
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4045 | AL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236038400000",
"number": "1174763221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "810 CHATTIE JAMES DR",
"city": "TUSKEGEE",
"state": "AL",
"postal_code": "36083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4109 HWY 98 WEST",
"city": "SUMMIT",
"state": "MS",
"postal_code": "39666",
"telephone_number": "601-276-3900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLES",
"first_name": "SHANTICE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-03",
"last_updated": "2009-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AL",
"license": "4045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summit, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.