Brandy Jernigan Williams, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6609 Issued in NC

Practice address

105 Greenway View CT
Mount Holly, NC 28120-9478

Phone

(704) 907-4610

Fax

(704) 820-8025

NPI assigned

Feb 13, 2006

Last updated

Jul 24, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1407820012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 GREENWAY VIEW CT",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281209478",
            "telephone_number": "704-907-4610",
            "fax_number": "704-820-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 GREENWAY VIEW CT",
            "city": "MOUNT HOLLY",
            "state": "NC",
            "postal_code": "281209478",
            "telephone_number": "704-907-4610",
            "fax_number": "704-820-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "BRANDY",
        "middle_name": "JERNIGAN",
        "name_prefix": "Mrs.",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "6609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7412342",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Mount Holly, NC
• Providers in Mount Holly, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.