Active NPI
Juilann Marie Ford, M.A., CCCSLP
- Speech-Language Pathologist
- South Bend, IN
National Provider Identifier
1447395447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 22001708A
- Practice address
- 108 N Main St
Suite 820
South Bend, IN 46601-1625 - Phone
- (574) 234-7244
- Fax
- (574) 234-9663
- NPI assigned
- Feb 20, 2007
- Last updated
- Jul 9, 2007
- 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 | 22001708A | IN | Primary |
Addresses
Primary practice location
108 N Main St
Suite 820
South Bend, IN 46601-1625
Mailing address
108 N Main St
Suite 820
South Bend, IN 46601-1625
Phone (574) 234-7244
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000195716 | Other | IN | BLUE CROSS BLUE SHIELD |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22001708A | IN | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1447395447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"address_2": "SUITE 820",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011625",
"telephone_number": "574-234-7244",
"fax_number": "574-234-9663"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 N MAIN ST",
"address_2": "SUITE 820",
"city": "SOUTH BEND",
"state": "IN",
"postal_code": "466011625",
"telephone_number": "574-234-7244",
"fax_number": "574-234-9663"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORD",
"first_name": "JUILANN",
"middle_name": "MARIE",
"credential": "M.A., CCCSLP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-20",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IN",
"license": "22001708A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "000000195716",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Bend, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.