Shannon Nicole Lieblong, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

1765 Issued in TN

Practice address

5625 Poplar Ave
Memphis, TN 38119-3816

Phone

(901) 761-1220

Fax

(901) 763-4332

NPI assigned

Jul 26, 2016

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

• Shannon Nicole Walker 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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1942753041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5625 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193816",
            "telephone_number": "901-761-1220",
            "fax_number": "901-763-4332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5625 POPLAR AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193816",
            "telephone_number": "901-761-1220",
            "fax_number": "901-763-4332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBLONG",
        "first_name": "SHANNON",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TN",
            "license": "1765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANNON",
            "last_name": "WALKER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erica Nicole Liddell
• Sheila Annette Liddell, PHARM D
• Gerald J Lieberman, MD
• Jay Adam Lieberman, M.D.
• Phillip L Lieberman, MD
• Lisa Liebschwager
• Christopher W Lievens, OD
• Life Balance Therapy, LLC (Ebony Bailey)
• Life Changing Foundation
• Life Changing World Outreach Community Development Corporation Inc

• Audiologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Audiologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.