Individual provider Active NPI

Christine Johnson Popp, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Richmond, VA
National Provider Identifier
1164783585
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202006636 Issued in VA
Practice address
2924 Brook Rd
Children'S Hosp of Richmond @ Vcu Credentilaing Dept
Richmond, VA 23220-1215
Phone
(804) 321-7474
Fax
(804) 228-5210
NPI assigned
Jun 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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 2202006636 VA Primary

Addresses

Primary practice location

2924 Brook Rd
Children'S Hosp of Richmond @ Vcu Credentilaing Dept
Richmond, VA 23220-1215

Mailing address

2924 Brook Rd
Children'S Hosp of Richmond @ Vcu Credentilaing Dept
Richmond, VA 23220-1215
Phone (804) 321-7474

Other identifiers 1

IdentifierTypeStateIssuer
4909976MedicaidVA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202006636VAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1164783585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CHILDREN'S HOSP OF RICHMOND @ VCU CREDENTILAING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201215",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 BROOK RD",
            "address_2": "CHILDREN'S HOSP OF RICHMOND @ VCU CREDENTILAING DEPT",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232201215",
            "telephone_number": "804-321-7474",
            "fax_number": "804-228-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPP",
        "first_name": "CHRISTINE",
        "middle_name": "JOHNSON",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-01",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4909976",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.