Camille Johnson, MS CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP009511 Issued in GA

Practice address

2959 Legacy Park Dr
Lithia Springs, GA 30122-4344

Phone

(803) 413-0489

NPI assigned

Dec 31, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Empowerme Rehabilitation Georgia, LLCGroup PAC ID 4284063835, 80 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Empowerme Rehabilitation Georgia, LLC

  • Multi-Specialty Clinic/Center
  • Cumming, GA
  • NPI 1952934374

  Speech-Language Pathologist

  Medicare reassignment Care Compare group NPD
• Phoenix Therapy Solutions LLC

  • Speech-Language Pathologist
  • Lithia Springs, GA
  • NPI 1710684899
  NPD Authorized official

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

{
    "created_epoch": "1483142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1063957975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2959 LEGACY PARK DR",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301224344",
            "telephone_number": "803-413-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2959 LEGACY PARK DR",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301224344",
            "telephone_number": "803-413-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAMILLE",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-31",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP009511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Jasper, MS, LAPC, NCC
• Tia Lanez Jeffers, DDS
• Laquanda Jefferson
• Gregory Jemison
• Kenia Johnson Lewis, PH.D.
• Otis Franflyn Johnson
• Temeka L Johnson
• Zachary Johnson, COF
• Shevon Jones
• Jonvi Cares LLC

• Speech-Language Pathologist in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.