Active NPI
Delores Michelle Johnson
- Speech-Language Pathologist
- Brandywine, MD
National Provider Identifier
1255804001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 06884
- Practice address
- 8506 Heatherwick Dr
Brandywine, MD 20613-7881 - Phone
- (317) 408-6367
- NPI assigned
- Jan 4, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 06884 | MD | Primary |
Addresses
Primary practice location
8506 Heatherwick Dr
Brandywine, MD 20613-7881
Mailing address
8506 Heatherwick Dr
Brandywine, MD 20613-7881
Phone (317) 408-6367
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546560000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546560000000",
"number": "1255804001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8506 HEATHERWICK DR",
"city": "BRANDYWINE",
"state": "MD",
"postal_code": "206137881",
"telephone_number": "317-408-6367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8506 HEATHERWICK DR",
"city": "BRANDYWINE",
"state": "MD",
"postal_code": "206137881",
"telephone_number": "317-408-6367"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DELORES",
"middle_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-04",
"last_updated": "2019-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MD",
"license": "06884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandywine, MD
- JM Group Homes
- Joan Healthcare Servces
- Johns Hopkins Community Physicians
- Johns Hopkins Community Physicians, Inc
- Clarence McNeil Johnson Jr., CRNP-PMH
- Derrick Jerod Johnson, MS
- Ka'Ra Caprie Johnson, LCSW-C, LCSW
- Anita Bonsu Jones, MD
- Just Breathe Recovery and Wellness Centers, LLC
- Magrace Vanessa Kamdem Simo
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.