Active NPI
Julie Sippel Dickinson, MCD, CCC-SLP
- Speech-Language Pathologist
- Shreveport, LA
National Provider Identifier
1316614449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 4406
- Practice address
- 9075 Kingston Rd
Shreveport, LA 71118-3415 - Phone
- (318) 686-1974
- Fax
- (318) 688-4459
- NPI assigned
- Aug 26, 2021
- Sex
- Female
- Sole proprietor
- No
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 | 4406 | LA | Primary |
Addresses
Primary practice location
9075 Kingston Rd
Shreveport, LA 71118-3415
Mailing address
1170 Ontario St
Shreveport, LA 71106-1414
Phone (318) 465-1276
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4406 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1316614449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1170 ONTARIO ST",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711061414",
"telephone_number": "318-465-1276"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9075 KINGSTON RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183415",
"telephone_number": "318-686-1974",
"fax_number": "318-688-4459"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKINSON",
"first_name": "JULIE",
"middle_name": "SIPPEL",
"name_prefix": "Mrs.",
"credential": "MCD, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "LA",
"license": "4406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.