Paula Mischelle Tibbs, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2009013463 Issued in MO

Practice address

710 Glenn Dr
Sikeston, MO 63801-3926

Phone

(573) 472-5360

NPI assigned

Dec 19, 2022

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

Other names 1

• Mischelle Tibbs Other name

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": "1671408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671408000000",
    "number": "1194437319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21292 COUNTY ROAD 306",
            "city": "ORAN",
            "state": "MO",
            "postal_code": "637718248",
            "telephone_number": "573-429-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 GLENN DR",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638013926",
            "telephone_number": "573-472-5360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBS",
        "first_name": "PAULA",
        "middle_name": "MISCHELLE",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-19",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2009013463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MISCHELLE",
            "last_name": "TIBBS",
            "credential": "CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Riyadh J Tellow, MD
• David V Terrell, LCSW
• Jenna Michelle Thomas, MOTR/L
• Jessica Michelle Thompson, RN
• Molly Rebecca Thompson, NCC, LPC
• Misty Tilmon, M.A. CCC-SLP
• Leslie Ann Timlin, M.S., CCC-SLP
• Alexandra Tomaszewski, LCSW
• David Leroy Tongate, DDS
• Tammy Renea Toon

• Speech-Language Pathologist in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; 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.