Individual provider Active NPI

Caroline Haddox Johnson, MCD, CCC-SLP

  • Speech-Language Pathologist
  • Harrisonburg, VA
National Provider Identifier
1215627401
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2202009924 Issued in VA
Practice address
463 E Washington St
Harrisonburg, VA 22802-4853
Phone
(540) 433-3100
Fax
(540) 434-0132
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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 2202009924 VA Primary

Addresses

Primary practice location

463 E Washington St
Harrisonburg, VA 22802-4853

Mailing address

1241 N Main St
Harrisonburg, VA 22802-4632
Phone (540) 434-1941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250310000874 VA Practitioner - Qualified Speech Language Pathologist 5294256053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2202009924VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Feb 3, 2025 Accepting new patients
Legacy Healthcare Services Inc Speech-Language Pathologist CurrentSince Feb 3, 2025 Accepting new patients
Harrisonburg-Rockingham Community Services Board PastSince May 14, 2023 Accepting new patients
Harrisonburg Rockingham Community Services Board PastSince May 14, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

343 Archer Ave
Charlottesville, VA 22911
Phone (434) 255-0996

3365 Ogden Rd
Roanoke, VA 24018
Phone (540) 682-7500

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1215627401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 N MAIN ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228024632",
            "telephone_number": "540-434-1941",
            "fax_number": "540-434-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 E WASHINGTON ST",
            "city": "HARRISONBURG",
            "state": "VA",
            "postal_code": "228024853",
            "telephone_number": "540-433-3100",
            "fax_number": "540-434-0132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CAROLINE",
        "middle_name": "HADDOX",
        "credential": "MCD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202009924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisonburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.