Individual provider Active NPI

Julie Johnson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Memphis, TN
National Provider Identifier
1174812754
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
12008877
Practice address
6000 Poplar Ave Ste 250
Memphis, TN 38119
Phone
(901) 231-9805
Fax
(800) 400-7659
NPI assigned
Apr 4, 2011
Last updated
Jun 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

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 12008877 Primary

Addresses

Primary practice location

6000 Poplar Ave Ste 250
Memphis, TN 38119

Mailing address

1005 Stagg Rd
Oakland, TN 38060-4149
Phone (901) 231-9805

Other practice location 1

1005 Stagg Rd
Oakland, TN 38060-4149
Phone (970) 213-0003

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)
Enrolled
Credentials
Master of Science

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1174812754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 STAGG RD",
            "city": "OAKLAND",
            "state": "TN",
            "postal_code": "380604149",
            "telephone_number": "901-231-9805",
            "fax_number": "888-400-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 POPLAR AVE STE 250",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38119",
            "telephone_number": "901-231-9805",
            "fax_number": "800-400-7659"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 Stagg Rd",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "TN",
            "postal_code": "380604149",
            "country_code": "US",
            "telephone_number": "970-213-0003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JULIE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-04",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "12008877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.