Individual provider Active NPI

Joanna Maria-Arnold Adcock, M.S. CCC-SLP

  • Speech-Language Pathologist
  • Gulfport, MS
National Provider Identifier
1083137749
Registry record updated Dec 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
1423 Magnolia St Apt D
Gulfport, MS 39507-3569
Phone
(228) 256-6015
Fax
(228) 206-6978
NPI assigned
Jul 24, 2017
Last updated
Dec 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2022

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 Primary

Addresses

Primary practice location

1423 Magnolia St Apt D
Gulfport, MS 39507-3569

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 777-6236

Other practice location 1

4700 Hardy St Ste J1
Hattiesburg, MS 39402-1300
Phone (601) 336-5236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221229002747 MS Practitioner - Qualified Speech Language Pathologist 3274903604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Mississippi LLC Speech-Language Pathologist CurrentSince Nov 21, 2022 Accepting new patients
Dpti Elite Physical Therapy LLC Speech-Language Pathologist Past Accepting new patients
Drayer Physical Therapy Mississippi LLC Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

4700 Hardy St
Ste J1
Hattiesburg, MS 39402
Phone (601) 336-5236

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671148800000",
    "number": "1083137749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-777-6236",
            "fax_number": "423-777-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 MAGNOLIA ST APT D",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073569",
            "telephone_number": "228-256-6015",
            "fax_number": "228-206-6978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Hardy St Ste J1",
            "address_purpose": "LOCATION",
            "city": "Hattiesburg",
            "state": "MS",
            "postal_code": "394021300",
            "country_code": "US",
            "telephone_number": "601-336-5236",
            "fax_number": "601-255-5458",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADCOCK",
        "first_name": "JOANNA",
        "middle_name": "MARIA-ARNOLD",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-24",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.