Courtney Nicole Shaw, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S3475 Issued in MS

Practice address

316 Rocky Hill Road
Louisville, MS 39339

Phone

(662) 803-5250

NPI assigned

Mar 18, 2016

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

• Miss Courtney Nicole Puckett 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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1326409335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 ROCKY HILL ROAD",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "39339",
            "telephone_number": "662-803-5250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 ROCKY HILL ROAD",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "39339",
            "telephone_number": "662-803-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAW",
        "first_name": "COURTNEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNEY",
            "last_name": "PUCKETT",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Aleesha O Robinson, MS
• Kali Dempsey Rogers, FNP
• Hillary Rowe, PHARMD
• Leslie Sanchez, MS
• Shakila Seals, MS
• Brooke Smith
• Marquita Smith, MS
• William E Smith, DMD
• Southern Pharmaceutical Corporation
• Starkville Surgical Clinic PA

• Speech-Language Pathologist in Louisville, MS
• Providers in Louisville, MS by specialty
• Speech-Language Pathologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.