Individual provider Active NPI

Shannon Jeanne Simpson, MCDCCCSLP

  • Speech-Language Pathologist
  • Jonesboro, AR
National Provider Identifier
1679599641
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP # 1874 Issued in AR
Practice address
2350 County Road 766
Jonesboro, AR 72401-6982
Phone
(870) 268-8448
Fax
(870) 268-8448
NPI assigned
Jul 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP # 1874 AR Primary

Addresses

Primary practice location

2350 County Road 766
Jonesboro, AR 72401-6982

Mailing address

2350 County Road 766
Jonesboro, AR 72401-6982
Phone (870) 268-8448

Other identifiers 1

IdentifierTypeStateIssuer
SP #1874OtherARSTATE LICENSURE NUMBER

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SP # 1874ARMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679599641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 COUNTY ROAD 766",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016982",
            "telephone_number": "870-268-8448",
            "fax_number": "870-268-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 COUNTY ROAD 766",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724016982",
            "telephone_number": "870-268-8448",
            "fax_number": "870-268-8448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "SHANNON",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "MCDCCCSLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "SP # 1874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE NUMBER",
            "identifier": "SP #1874",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.