Active NPI
Virginia Clipson Johnson, MACCC-SLP
- Speech-Language Pathologist
- Bryan, TX
National Provider Identifier
1093065393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11157
- Practice address
- 1401 W. Martin Luther King
Bryan, TX 77803 - Phone
- (979) 209-3700
- NPI assigned
- Sep 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 11157 | TX | Primary |
Addresses
Primary practice location
1401 W. Martin Luther King
Bryan, TX 77803
Mailing address
1501 Copperfield Parkway #827
College Station, TX 77845
Phone (210) 601-6787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11157 | TX | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347494400000",
"number": "1093065393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 COPPERFIELD PARKWAY #827",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "77845",
"telephone_number": "210-601-6787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 W. MARTIN LUTHER KING",
"city": "BRYAN",
"state": "TX",
"postal_code": "77803",
"telephone_number": "979-209-3700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "VIRGINIA",
"middle_name": "CLIPSON",
"credential": "MACCC-SLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-13",
"last_updated": "2012-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "11157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.