Johanna Linnea Bozeman, M.ED., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SLP012557 Issued in GA

Practice address

112 Three West Pkwy
Villa Rica, GA 30180-4778

Phone

(770) 459-6533

Fax

(770) 462-1260

NPI assigned

Jun 21, 2022

Last updated

Jun 19, 2026By the provider in NPPES

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 names 1

• Johanna Wagner Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

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.

• Therapy Excellence

  • Physical Therapist
  • Villa Rica, GA
  • NPI 1992269807

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1655769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1154052041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 THREE WEST PKWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301804778",
            "telephone_number": "770-459-6533",
            "fax_number": "770-462-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 THREE WEST PKWY",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301804778",
            "telephone_number": "770-459-6533",
            "fax_number": "770-462-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOZEMAN",
        "first_name": "JOHANNA",
        "middle_name": "LINNEA",
        "credential": "M.ED., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-21",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP012557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "WAGNER",
            "credential": "M.ED., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsea Grant Bode, M.ED., CCC-SLP
• William Todd Boleman, MD
• Bonnie Kristine Boles, M.D.
• Yolanda Therese Booker, LPN
• James Larry Boss, M.D.
• Carter Dale Brannon, R.PH.
• Brian a Bain DDS III PC
• Ann Hamilton Brown, MASTERS
• Benita N Brown, NP
• Jacqueline Brown, NP

• Speech-Language Pathologist in Villa Rica, GA
• Providers in Villa Rica, 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 Jun 19, 2026; 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.