Dorothy Fullilove Johnson, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2485 Issued in AR

Practice address

1616 N Vine
Magnolia, AR 71753-9740

Phone

(870) 725-6393

NPI assigned

Mar 9, 2007

Last updated

Sep 14, 2007By 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 names 1

• D. Michelle Johnson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189728000000",
    "number": "1649302431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1012",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717111012",
            "telephone_number": "870-725-6393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 N VINE",
            "city": "MAGNOLIA",
            "state": "AR",
            "postal_code": "717539740",
            "telephone_number": "870-725-6393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOROTHY",
        "middle_name": "FULLILOVE",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AR",
            "license": "2485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "D. MICHELLE",
            "last_name": "JOHNSON",
            "credential": "M.A., CCC-SLP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Speech-Language Pathologist in Magnolia, AR
• Providers in Magnolia, AR by specialty
• Speech-Language Pathologist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.

Verify at the official NPI Registry.