Shannon Kay Salter Fussell, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3339 Issued in GA

Practice address

Forest Dr
Counseling and Career Development Center
Statesboro, GA 30460-0001

Phone

(912) 478-5541

NPI assigned

Jan 11, 2010

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

• Miss Shannon Kay Salter Former name

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Compass Psychological Associates, PLLCGroup PAC ID 5698212413, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Compass Psychological Associates, PLLC

  • Psychologist
  • Ocean Springs, MS
  • NPI 1427890151

  MS, Psychologist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263168000000",
    "number": "1851621080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 FLORENCE AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304585138",
            "telephone_number": "912-225-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOREST DR",
            "address_2": "COUNSELING AND CAREER DEVELOPMENT CENTER",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304600001",
            "telephone_number": "912-478-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "SHANNON",
        "middle_name": "KAY SALTER",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2010-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "3339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "SALTER",
            "middle_name": "KAY",
            "prefix": "MISS",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Wendy Futch, NP
• Howard M Gale, DPM
• Merry Gallagher, PHD
• Kacey Gammon, LPC
• Dwayne Thomas Gard, MD

• All providers in Statesboro, GA
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.