Individual provider Active NPI

Shirley Caroline Heathcock

  • Speech-Language Pathologist
  • Mesquite, TX
National Provider Identifier
1194556696
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
122894 Issued in TX
Practice address
3500 Pioneer Rd
Mesquite, TX 75180-2404
Phone
(972) 882-7280
NPI assigned
Aug 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 122894 TX Primary

Addresses

Primary practice location

3500 Pioneer Rd
Mesquite, TX 75180-2404

Mailing address

714 E Kimbrough St
Mesquite, TX 75149-4420
Phone (972) 882-7700

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

LicenseStateTypeSpecialty
122894TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mesquite Independent School District PastSince Aug 11, 2024 Accepting new patients
Sunnyvale Independent School District PastSince Aug 11, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1194556696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 E KIMBROUGH ST",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751494420",
            "telephone_number": "972-882-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 PIONEER RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751802404",
            "telephone_number": "972-882-7280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHCOCK",
        "first_name": "SHIRLEY",
        "middle_name": "CAROLINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "122894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; 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.