Individual provider Active NPI

Kamryn Johnson

  • Speech-Language Pathologist
  • Tulsa, OK
National Provider Identifier
1083463087
Registry record updated Jan 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6568 Issued in OK
Practice address
8125 E 101St St Ste 50
Tulsa, OK 74133-7245
Phone
(918) 392-7600
Fax
(405) 548-4350
NPI assigned
May 14, 2024
Last updated
Jan 23, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6568 OK Primary

Addresses

Primary practice location

8125 E 101St St Ste 50
Tulsa, OK 74133-7245

Mailing address

11500 N Portland Ave
Oklahoma City, OK 73120-4625
Phone (405) 548-4300

Other practice location 1

11500 N Portland Ave
Oklahoma City, OK 73120-4625
Phone (405) 548-4300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260406000423 OK Practitioner - Qualified Speech Language Pathologist 2062987308 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11500 N Portland Ave
Oklahoma City, OK 73120-4625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6568OKMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hearts for Hearing Foundation Speech-Language Pathologist CurrentSince Sep 8, 2025 Accepting new patients

Locations

11500 N Portland Ave
Oklahoma City, OK 73120
Phone (405) 548-4300

8125 E 101st St
Ste 50
Tulsa, OK 74133
Phone (918) 392-7600

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1083463087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11500 N PORTLAND AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731204625",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8125 E 101ST ST STE 50",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741337245",
            "telephone_number": "918-392-7600",
            "fax_number": "405-548-4350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11500 N Portland Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731204625",
            "country_code": "US",
            "telephone_number": "405-548-4300",
            "fax_number": "405-548-4350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAMRYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "6568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.