Kerry Johnson

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL012308 Issued in PA

Practice address

853 Parkridge Drive
Media, PA 19063

Phone

(610) 742-5291

NPI assigned

Apr 29, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1063867869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "853 PARKRIDGE DRIVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-742-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "853 PARKRIDGE DRIVE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "19063",
            "telephone_number": "610-742-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KERRY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "PA",
            "license": "SL012308",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00793600",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John L Brendler, Inc
• Crystalle Johnson, CNM
• Jaime Johnson, PA-C
• Jermaine Marcell Johnson, MS, ABA, MBA
• Jerome Maurice Johnson, MS, ABA, MBA
• Mark Donald Johnston, PT
• Erika Sasha Jones, CCC-SLP
• Jade Alexa Jones
• Keyairrah Jones
• Scott Edgar Jones, DPM

• Speech-Language Pathologist in Media, PA
• Providers in Media, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.