Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1508153016 Individual Practitioner Female Practitioner

Nicole Kristen Johnson , MS, CCC-SLP

Speech-Language Pathologist • Winder, GA

Professional Overview & Biography Verified Profile Summary

Nicole Johnson, MS, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Winder, GA. Practice services are available at 204 RESOURCE LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

204 Resource Ln

Winder, GA 306808361

Telephone 6789630694
Fax 8885474008
Associated Practice Facility / Clinic
🏢 Let's Communicate, Inc Facility NPI 1467696393

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Winder, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
20 Specialists

Practicing in Winder, GA (4796 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License FL SZ5470

The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
003183165A (GA)
Medicaid State Provider ID
004036600 (FL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

22 Associated Practitioners
Dr. Laura Ashford , OTD, OTR, L

Occupational Therapist

NPI 1043017577

Doctor of Occupational Therapy, Occupational Therapist Registered, L

Jill Rodibaugh , CCC-SLP

Speech-Language Pathologist

NPI 1043383896

Speech-Language Pathologist (Certificate of Clinical Competence)

Erica White

Occupational Therapist

NPI 1083022644
Chandler Fortson , MED, CCC-SLP

Speech-Language Pathologist

NPI 1154858207

Master of Education, Speech-Language Pathologist (Certificate of Clinical Competence)

Caroline Petmecky

Physical Therapist

NPI 1225757461
Melissa Bishop

Speech-Language Pathologist

NPI 1255008454

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
NPI Profile Active February 07, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location February 07, 2017

Registered at 204 RESOURCE LN, WINDER, GA 306808361 (Tel: 6789630694)

📍
Updated Business Mailing Address February 07, 2017

Registered at 204 RESOURCE LN, WINDER, GA 306808361 (Tel: 6789630694)

👤
Provider Name / Credentials Updated February 07, 2017

Recorded as NICOLE JOHNSON, MS, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 07, 2017

Speech-Language Pathologist (License #SZ5470 in FL)

NPI Profile Active July 17, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location July 17, 2012

Registered at 1955 N FEDERAL HWY, SUITE 253, POMPANO BEACH, FL 330621028 (Tel: 9545802520)

📍
Updated Business Mailing Address July 17, 2012

Registered at 1955 N FEDERAL HWY, SUITE 253, POMPANO BEACH, FL 330621028 (Tel: 9545802520)

👤
Provider Name / Credentials Updated July 17, 2012

Recorded as NICOLE BOCK, MS, CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2012

Speech-Language Pathologist (License #SZ5470 in FL)

🟢
Initial NPI Registration & Enumeration July 05, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1508153016
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 05, 2011
Last Update: February 07, 2017
Sole Proprietor: No

Mailing Address

204 Resource Ln

Winder, GA 306808361

Phone: 6789630694

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.