Shannon Mitchell Dukes – Speech-Language Pathologist

Key facts

NPI: 1508129180
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 5075 (SC)
Practice address: 521 Caro Lane
Chapin, SC 29036-7951
Phone: (864) 833-2550
NPI assigned: Jun 19, 2012
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
5075	SC	MD	Pediatric Occupational Therapist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	5075	SC	Yes

Addresses

Primary practice location

521 Caro Lane
Chapin, SC 29036-7951

Mailing address

521 Caro LN
Chapin, SC 29036-7951
Phone (803) 645-4597

Other names

Shannon Deneece Mitchell Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 29, 2015.

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1508129180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 CARO LN",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290367951",
            "telephone_number": "803-645-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 CARO LANE",
            "city": "CHAPIN",
            "state": "SC",
            "postal_code": "290367951",
            "telephone_number": "864-833-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUKES",
        "first_name": "SHANNON",
        "middle_name": "MITCHELL",
        "name_prefix": "Miss",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "MITCHELL",
            "middle_name": "DENEECE",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chapin, SC

April Maranville Dowdee, MSN, APRN-BC, AE-C
Abbi Katherine Dowell, M.S. SLP-CCC
Drayer Physical Therapy-South Carolina, LLC
Dream Big Therapy Solutions, LLC
Tracy J Duckworth, PTA
Austin Gregory Dunn, DPT
Kimberly Echerer
Cynthia J Ekman, PT
Campbell Olivia Ellis, RBT
Gail Elmore, PH. D.

All providers in Chapin, SC · Speech-Language Pathologist in South Carolina

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 29, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.