Individual provider Active NPI

Julie Ana Boozer

  • Speech-Language Pathologist
  • Chattanooga, TN
National Provider Identifier
1417428392
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
4514 Issued in TN
Practice address
1005 Stone Ledge LN
Chattanooga, TN 37421-4769
Phone
(256) 415-9997
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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 4514 TN Primary

Addresses

Primary practice location

1005 Stone Ledge LN
Chattanooga, TN 37421-4769

Mailing address

1005 Stone Ledgr Lane
Chattanooga, TN 37421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190322001960 TN Practitioner - Qualified Speech Language Pathologist 9830439108 Reassigns benefits to 1 organization
I20190702001834 GA Practitioner - Qualified Speech Language Pathologist 9830439108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4514TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group Inc. CurrentSince Jan 7, 2019 Accepting new patients
Paxxon Healthcare Services LLC Speech-Language Pathologist CurrentSince Sep 1, 2021 Accepting new patients
Paxxon Healthcare Services LLC CurrentSince Sep 1, 2021 Accepting new patients
The Weston Group Inc. Speech-Language Pathologist CurrentSince Jan 7, 2019 Accepting new patients
Hamilton County Department of Education Past Accepting new patients

Locations

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

Organizations & group practices 5

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1417428392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 STONE LEDGR LANE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 STONE LEDGE LN",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214769",
            "telephone_number": "256-415-9997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOZER",
        "first_name": "JULIE ANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "4514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; 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.