Shontel Denise Wilson, MS,CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP#2448 Issued in AR

Practice address

300 Eldridge Rd
Suite 1
Forrest City, AR 72335

Phone

(870) 633-3278

NPI assigned

Dec 21, 2007

Last updated

Dec 21, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1255515581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "479 SPRINGWAY DR",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723352921",
            "telephone_number": "901-634-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ELDRIDGE RD",
            "address_2": "SUITE 1",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "72335",
            "telephone_number": "870-633-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHONTEL",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP#2448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Wilborn
• Jordan Wilkison, LAC
• Holly Rae Willard, BS,CCS,CADC
• Kiffany Williams
• Meredith Anne Williams, M.D.
• Lashunda Winfrey, CM/ACTIVITY THERP.
• Eric R Wood, CRNA
• Tamikak Woodard, CASE MANAGER
• Woodridge of Forrest City, LLC (Perimeter Behavioral of Forrest City)
• Alisha Nichol Wyatt, M.D.

• Speech-Language Pathologist in Forrest City, AR
• Providers in Forrest City, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; 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.