Pamela Johnson Desimone, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

004011 Issued in CT

Practice address

1145 Poquonnock Rd
Groton, CT 06340-4620

Phone

(860) 446-3134

NPI assigned

Mar 28, 2012

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

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Inspire Physical Therapy and Wellness, LLC

  • Physical Therapist
  • Westerly, RI
  • NPI 1548847221
  Medicare reassignment NPD

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

{
    "created_epoch": "1332892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1760758247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 POQUONNOCK RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063404620",
            "telephone_number": "860-446-3134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESIMONE",
        "first_name": "PAMELA",
        "middle_name": "JOHNSON",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-28",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "004011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taylor Del Viscovo, PA
• Jose Luis Delgado III
• Ellen Catherine Denigris, MD
• Dependable Home Care of CT LLC
• Shrikant R Deshpande, MD, MPH
• Mark Alfred Desjardins, MD
• Lauren Anne Dessereaux, OTR/L
• Christopher David Deveau, DC
• Sterling Eugene Deveraux, MSW
• Shaun Singh Dhillon, OD

• Speech-Language Pathologist in Groton, CT
• Providers in Groton, CT by specialty
• Speech-Language Pathologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.