Shannon Thompson, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202008214 Issued in VA

Practice address

4560 South Blvd Ste 310
Virginia Beach, VA 23452-1160

Phone

(757) 490-3223

Fax

(757) 490-2936

NPI assigned

Apr 17, 2018

Last updated

Jan 24, 2020By the provider in NPPES

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

Other names 1

• Shannon Black 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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579824000000",
    "number": "1497242333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4560 SOUTH BLVD STE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521160",
            "telephone_number": "757-490-3223",
            "fax_number": "757-490-2936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4560 SOUTH BLVD STE 310",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521160",
            "telephone_number": "757-490-3223",
            "fax_number": "757-490-2936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "SHANNON",
        "name_prefix": "Miss",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2020-01-24",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202008214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "BLACK",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patience Thompson
• Paul R Thompson, D.C.
• Princess Thompson
• Rhianna Lawson Thompson, MS
• Rosemary A Thompson, LPC, NCC, NCSC, RPT
• Sherry Thompson
• Stephen Richard Thompson, PT
• Susan Thompson, LCSW
• Suzan K Thompson, PH.D., LPC
• Tara Ashley Thompson

• Speech-Language Pathologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2020; 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.