Shannon Rae Throgmorton

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146014604 Issued in IL

Practice address

955 Villa CT
Carbondale, IL 62901-6001

Phone

(618) 351-7955

NPI assigned

Nov 17, 2021

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)

Enrolled

State licenses

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

{
    "created_epoch": "1637107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1205592938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7730 CARONDELET AVE",
            "city": "CLAYTON",
            "state": "MO",
            "postal_code": "631053314",
            "telephone_number": "844-502-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 VILLA CT",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629016001",
            "telephone_number": "618-351-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THROGMORTON",
        "first_name": "SHANNON",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-17",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146014604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myranda Nicole Thomas
• Edward Brent Thompson, ATC
• Madison Thompson, BSW
• Trent Logan Thompson, DPT
• Justin Keith Thorpe, MD,DC
• Rosemary Lynn Ticer, COTA/L
• Brittany Perrotta Tillman, MSW,LCSW
• Jennifer Ting, CNM
• Valerie Jean Ting, ARNP
• Tabitha Toland

• Speech-Language Pathologist in Carbondale, IL
• Providers in Carbondale, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.