Teresa Lynn Boggs, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

1220 Issued in TN

Practice address

156 S Dossett Drive
Johnson City, TN 37614-1702

Phone

(423) 439-4355

Fax

(423) 439-4607

NPI assigned

Jan 5, 2007

Last updated

Jan 16, 2024By 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medical Education Assistance Corporation

  • Speech-Language Pathologist
  • Johnson City, TN
  • NPI 1164062659
  NPD (past)
• Medical Education Assistance Corporation

  dba ETSU Speech & Hearing Center

  • Speech-Language Pathologist
  • Johnson City, TN
  • NPI 1962432609
  NPD (past)

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1598812158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 699",
            "city": "MOUNTAIN HOME",
            "state": "TN",
            "postal_code": "376840699",
            "telephone_number": "423-439-4584",
            "fax_number": "423-439-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S DOSSETT DRIVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376141702",
            "telephone_number": "423-439-4355",
            "fax_number": "423-439-4607"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Jason Witten Way",
            "address_purpose": "LOCATION",
            "city": "Elizabethton",
            "state": "TN",
            "postal_code": "376432970",
            "country_code": "US",
            "telephone_number": "423-439-4355",
            "fax_number": "423-543-0581",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2423 Susannah St",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376011749",
            "country_code": "US",
            "telephone_number": "423-915-9257",
            "fax_number": "423-439-4607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "1220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510971",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE LICENSE",
            "identifier": "SP1220",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Holloway Blythe
• Bobby D Reynolds II
• Leslie Bodo, FNP-BC
• Siegfried Hans Boehm
• Anna Bogart, LPC
• Charissa Bogle, LCSW
• Mikayla L. Bogulski
• Cydney Boldt, DO
• Olivia Cathryn Boles, DPT
• Savannah R Boles, RT(R)(MR)RN

• Speech-Language Pathologist in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.