Provider Demographics
NPI:1730653627
Name:RHODES, SHEMELL (RRT/RCP)
Entity Type:Individual
Prefix:
First Name:SHEMELL
Middle Name:
Last Name:RHODES
Suffix:
Gender:F
Credentials:RRT/RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 E SCARLETT LN
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-7137
Mailing Address - Country:US
Mailing Address - Phone:843-617-9725
Mailing Address - Fax:
Practice Address - Street 1:500 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2616
Practice Address - Country:US
Practice Address - Phone:843-777-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCRCP5916LL227900000X
227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCRCP5916OtherRESPIRATORY THERAPIST