Individual provider Active NPI

Olivia Johnson Spaulding

  • Speech-Language Pathologist
  • Rockwall, TX
National Provider Identifier
1760027064
Registry record updated Nov 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
109488 Issued in TX
Practice address
401 W Washington St
Rockwall, TX 75087-3615
Phone
(972) 722-3892
NPI assigned
Nov 10, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2019

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 109488 TX Primary

Addresses

Primary practice location

401 W Washington St
Rockwall, TX 75087-3615

Mailing address

401 W Washington St
Rockwall, TX 75087-3615
Phone (972) 722-3892

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

State licenses

LicenseStateTypeSpecialty
109488TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wilson Sisters, LLC Past Accepting new patients

Organizations & group practices 1

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": "1573344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573344000000",
    "number": "1760027064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W WASHINGTON ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873615",
            "telephone_number": "972-722-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W WASHINGTON ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873615",
            "telephone_number": "972-722-3892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAULDING",
        "first_name": "OLIVIA",
        "middle_name": "JOHNSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-10",
        "last_updated": "2019-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "109488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2019; 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.