Shelby Smith Thames

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

S-3973 Issued in MS

Practice address

921 W Beacon Street
Philadelphia, MS 39350

Phone

(601) 650-0002

Fax

(601) 650-9902

NPI assigned

Sep 12, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Shelby Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612656000000",
    "number": "1639729510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 W BEACON STREET",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "39350",
            "telephone_number": "601-650-0002",
            "fax_number": "601-650-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 W BEACON STREET",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "39350",
            "telephone_number": "601-650-0002",
            "fax_number": "601-650-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAMES",
        "first_name": "SHELBY",
        "middle_name": "SMITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-12",
        "last_updated": "2021-02-07",
        "certification_date": "2021-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S-3973",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MS",
            "license": "S3973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHELBY",
            "last_name": "SMITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Richard Kent Stribling, O.D.
• Trent A Stribling, O.D.
• Surgery Clinic of Philadelphia
• Kimberly Nicole Tadlock, RDN
• Katie Taylor, CMHC
• The Medical Store, Inc.
• Denita Kaye Thomas, FNP
• Julie Thomas
• Thomasson Land Holdings, LLC
• Hailey Elizabeth Thompson, DO

• Speech-Language Pathologist in Philadelphia, MS
• Providers in Philadelphia, 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 Feb 7, 2021; 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.