Johnson City Speech and Language Therapy

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Legal business name

JOHNSON CITY SPEECH AND LANGUAGE THERAPY

Practice address

2700 S Roan St Ste 425
Johnson City, TN 37601-7587

Phone

(423) 212-3853

NPI assigned

Mar 23, 2022

Organization subpart

No

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

Authorized official

Name

Dori Pennucci, MS, CCC/SLP

Title

Speech-Language Pathologist

Phone

(423) 212-3853

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kaley Daniel Briggs

  • Speech-Language Pathologist
  • Kingsport, TN
  • NPI 1194457028
  Medicare reassignment NPD

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

{
    "created_epoch": "1647993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1770232811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 S ROAN ST STE 425",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017587",
            "telephone_number": "423-212-3853",
            "fax_number": "423-805-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 S ROAN ST STE 425",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376017587",
            "telephone_number": "423-212-3853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON CITY SPEECH AND LANGUAGE THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-23",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "PENNUCCI",
        "authorized_official_first_name": "DORI",
        "authorized_official_title_or_position": "SPEECH-LANGUAGE PATHOLOGIST",
        "authorized_official_telephone_number": "423-212-3853",
        "authorized_official_credential": "MS, CCC/SLP"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q079383",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johnson City Medical Center
• Johnson City OB/GYN Associates
• Johnson City Oral and Maxillofacial Surgery, LLC
• Johnson City Physical Occupational Speech Outpatient Therapy, PLLC
• Johnson City Smiles, LLC
• Johnson City Urological Clinic, P.C.
• Johnson Hearing Technology and Communication, PLLC
• Abbey Lin Gillispie Johnson, MD
• Alexandra Nicole Johnson, DO
• Andrew Benjamin Johnson

• 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 Jul 2, 2024; 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.