Marilyn Johnson Dunham Wark, MA CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

0000000751 Issued in TN

Practice address

4055 N Park Loop
Memphis, TN 38152-5042

Phone

(901) 678-2009

NPI assigned

Dec 2, 2011

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 identifiers 1

Other names 1

• Marilyn Johnson Dunham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1104194331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 POPLAR AVE BLDG 2",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381054607",
            "telephone_number": "901-287-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 N PARK LOOP",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381525042",
            "telephone_number": "901-678-2009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARK",
        "first_name": "MARILYN",
        "middle_name": "JOHNSON DUNHAM",
        "name_prefix": "Ms.",
        "credential": "MA CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-02",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "0000000751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1527831",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARILYN",
            "last_name": "DUNHAM",
            "middle_name": "JOHNSON",
            "credential": "MA CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tera Brownlee Warfield, LPC/MHSP
• Suzanne Stevens Warford, M.D.
• Ashley Wargo, PA-S
• Monica Lynn Warhaftig, D.O.
• Lindsey Marie Waring, PTA
• Nancy Helmuth Wark
• Ginger H Warmath, APN
• Ariana Warner
• Ashley McCray Warner
• Elizabeth Kate Warners

• Speech-Language Pathologist in Memphis, TN
• Providers in Memphis, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.