Active NPI
Johanna Lidsky Gray, CFY-SLP
- Speech-Language Pathologist
- Vienna, VA
National Provider Identifier
1407578115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLPCF2000054
- Practice address
- 8229 Boone Blvd Ste 660
Vienna, VA 22182-2657 - Phone
- (703) 821-1363
- NPI assigned
- Sep 19, 2022
- 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 | SLPCF2000054 | DC | Primary |
Addresses
Primary practice location
8229 Boone Blvd Ste 660
Vienna, VA 22182-2657
Mailing address
31 Hayden LN
Franklin, MA 02038-1302
Phone (508) 269-5964
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 |
|---|---|---|---|
| SLPCF2000054 | DC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663545600000",
"number": "1407578115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 HAYDEN LN",
"city": "FRANKLIN",
"state": "MA",
"postal_code": "020381302",
"telephone_number": "508-269-5964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8229 BOONE BLVD STE 660",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822657",
"telephone_number": "703-821-1363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAY",
"first_name": "JOHANNA",
"middle_name": "LIDSKY",
"credential": "CFY-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-19",
"last_updated": "2022-09-19",
"certification_date": "2022-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "DC",
"license": "SLPCF2000054",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.