Shannon L Patrick, MSCCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

103525 Issued in TX

Practice address

1907 Refinery Rd
Gainesville, TX 76240-2111

Phone

(940) 665-0386

NPI assigned

Jul 18, 2017

Last updated

Mar 17, 2018By 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

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629591037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 HUDSON ST",
            "city": "CORINTH",
            "state": "TX",
            "postal_code": "762101618",
            "telephone_number": "940-536-5539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1907 REFINERY RD",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762402111",
            "telephone_number": "940-665-0386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3511 Corinth Pkwy",
            "address_purpose": "LOCATION",
            "city": "Corinth",
            "state": "TX",
            "postal_code": "762085384",
            "country_code": "US",
            "telephone_number": "940-270-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1900 E California St",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "TX",
            "postal_code": "762404400",
            "country_code": "US",
            "telephone_number": "940-668-6263",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATRICK",
        "first_name": "SHANNON",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "MSCCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "103525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Gainesville, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.