Nicole Johnson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

022791 Issued in NY

Practice address

160 Wallace Way BLDG 9
Rochester, NY 14624

Phone

(585) 617-2314

NPI assigned

May 25, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole P Johnson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Westside Speech and Language Pathology PLLC

  • Speech-Language Pathologist
  • Spencerport, NY
  • NPI 1750150819
  NPD Authorized official

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1659664571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 297",
            "city": "SPENCERPORT",
            "state": "NY",
            "postal_code": "145590297",
            "telephone_number": "716-984-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 WALLACE WAY BLDG 9",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14624",
            "telephone_number": "585-617-2314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 OConnor Rd",
            "address_purpose": "LOCATION",
            "city": "Fairport",
            "state": "NY",
            "postal_code": "144501327",
            "country_code": "US",
            "telephone_number": "585-419-8174",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "182 Queensland Dr",
            "address_purpose": "LOCATION",
            "city": "Spencerport",
            "state": "NY",
            "postal_code": "145592410",
            "country_code": "US",
            "telephone_number": "716-984-1296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202005855",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "022791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "JOHNSON",
            "middle_name": "P",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Michelle S Johnson, OPTICIAN
• Morisha Johnson
• Natalie Johnson
• Natasha L. Johnson, RPA-C
• Nathaniel Johnson, PMHNP-BC
• Olivia Rose Johnson
• Rachel Elizabeth Johnson
• Randi L Johnson, PA
• Rejanee Johnson
• Robert M Johnson, M.D.

• Speech-Language Pathologist in Rochester, NY
• Providers in Rochester, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.