Shannon Marie Thomas, SLP, MSP-CCC

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4399 Issued in NC

Practice address

8919 Park Rd
Charlotte, NC 28210-9600

Phone

(704) 551-6800

NPI assigned

Jun 15, 2017

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

Other names 1

• Shannon Marie Kenneally Former 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": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1316477987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9921 HOLLY CENTER DR APT 314",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280785154",
            "telephone_number": "704-728-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8919 PARK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282109600",
            "telephone_number": "704-551-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "SLP, MSP-CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "KENNEALLY",
            "middle_name": "MARIE",
            "credential": "MSP, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nikki Cashion Thomas, CRNA
• Porscha Thomas
• Rachel Morgan Thomas, PT
• Ruth Ann Thomas, LCAS
• Sarah Katherine Thomas, MD
• Shatoria Tyshon Thomas, LCMHCA, LCASA
• Shenequa Renee Thomas, LPC, CRC
• Sherill S Thomas
• Tamara Thomas
• Tanecia Lynn Thomas, BCBA

• Speech-Language Pathologist in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.