Active NPI
Patricia E Johnson, M.A.
- Hearing Instrument Specialist
- Riverton, WY
National Provider Identifier
1083831317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- 103
- Practice address
- 218 N Broadway Ave
Riverton, WY 82501-3543 - Phone
- (307) 856-3847
- Fax
- (307) 856-7484
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist-Hearing Aid Fitter | 237600000X | 103 | WY | |
| Hearing Instrument Specialist | 237700000X | 103 | WY | Primary |
Addresses
Primary practice location
218 N Broadway Ave
Riverton, WY 82501-3543
Mailing address
218 N Broadway Ave
Riverton, WY 82501-3543
Phone (307) 856-3847
Other practice location 1
107 S Broadway Ave
Suite 207
Riverton, WY 82501-4300
Phone (307) 856-3847
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 112093000 | Medicaid | WY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103 | WY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Timberline Hearing, P.C. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Hearing Aid Equipment
- Riverton, WY
- NPI 1003316639
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1083831317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "218 N BROADWAY AVE",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825013543",
"telephone_number": "307-856-3847",
"fax_number": "307-856-7484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 N BROADWAY AVE",
"city": "RIVERTON",
"state": "WY",
"postal_code": "825013543",
"telephone_number": "307-856-3847",
"fax_number": "307-856-7484"
}
],
"practiceLocations": [
{
"address_1": "107 S Broadway Ave",
"address_2": "Suite 207",
"address_purpose": "LOCATION",
"city": "Riverton",
"state": "WY",
"postal_code": "825014300",
"country_code": "US",
"telephone_number": "307-856-3847",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "PATRICIA",
"middle_name": "E",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "237600000X",
"taxonomy_group": "",
"desc": "Audiologist-Hearing Aid Fitter",
"state": "WY",
"license": "103",
"primary": false
},
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "WY",
"license": "103",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "112093000",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Riverton, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.