Active NPI
Dorothy Angela Brunson, M.S., CCC-SLP
- Speech-Language Pathologist
- Jackson, MS
National Provider Identifier
1821240524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- S2429
- Practice address
- 2500 N State St
Dept of Otolaryngology
Jackson, MS 39216-4500 - Phone
- (601) 984-4555
- NPI assigned
- Oct 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S2429 | MS | Primary |
Addresses
Primary practice location
2500 N State St
Dept of Otolaryngology
Jackson, MS 39216-4500
Mailing address
Dept #2130, PO Box 11407
Birmingham, AL 35246-2130
Phone (601) 925-6805
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00981345 | Medicaid | MS |
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389052800000",
"number": "1821240524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT #2130, PO BOX 11407",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352462130",
"telephone_number": "601-925-6805",
"fax_number": "601-926-4971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"address_2": "DEPT OF OTOLARYNGOLOGY",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-4555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUNSON",
"first_name": "DOROTHY",
"middle_name": "ANGELA",
"credential": "M.S., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-14",
"last_updated": "2014-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MS",
"license": "S2429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00981345",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.