Sally Phillips Junkins, M.S., CCC-SLP

Key facts

NPI

1922250596

Entity type

Individual (NPI type 1)

Primary specialty

Speech-Language Pathologist 235Z00000X

License

138564 (KY)

Practice address

3761 Johnson Hall Dr
Masonic Home, KY 40041-9998

Phone

(502) 293-1695

Fax

(502) 805-1511

NPI assigned

Oct 15, 2008

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Master of Science

State licenses

Interoperability endpoints

• Direct secure messaging: sjunkins7452@bhkydirect.com

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 7, 2023.

{
    "created_epoch": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1922250596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOWARD DR",
            "city": "SHELBYVILLE",
            "state": "KY",
            "postal_code": "400658138",
            "telephone_number": "502-633-1007",
            "fax_number": "502-805-1511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3761 JOHNSON HALL DR",
            "city": "MASONIC HOME",
            "state": "KY",
            "postal_code": "400419998",
            "telephone_number": "502-293-1695",
            "fax_number": "502-805-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUNKINS",
        "first_name": "SALLY",
        "middle_name": "PHILLIPS",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KY",
            "license": "138564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Masonic Home, KY · Speech-Language Pathologist in Kentucky