Nicola Ann Johnson, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

6994 Issued in TN

Practice address

65 Mouse Creek Rd NW
Cleveland, TN 37312-4840

Phone

(423) 476-7212

Fax

(423) 476-1673

NPI assigned

Jan 3, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1578009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578009600000",
    "number": "1831738145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 MOUSE CREEK RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124840",
            "telephone_number": "423-476-7212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MOUSE CREEK RD NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124840",
            "telephone_number": "423-476-7212",
            "fax_number": "423-476-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLA",
        "middle_name": "ANN",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-03",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN. DIVISION OF HEALTH LICENSURE AND REGULATION",
            "identifier": "6994",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@cdkidsmail.com",
            "affiliation": "N",
            "endpointDescription": "This is th secure email for the primary practice location",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "65 Mouse Creek Rd NW",
            "city": "Cleveland",
            "state": "TN",
            "country_code": "US",
            "postal_code": "373124840",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Denver Johnson, PA-C
• Jessica Partridge Johnson
• London B Johnson
• Lyle Foster Johnson, OTAL
• Machelle Johnson, LPC/MHSP
• Oliva P. Johnson
• Tamara Bilbo Johnson, ED.D., BCBA
• Tina Carney Johnson, FNP
• William Frank Johnson II, MD
• Amanda Rose Joliet, NP-C

• Speech-Language Pathologist in Cleveland, TN
• Providers in Cleveland, 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 Jan 3, 2020; 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.