Individual provider Active NPI

Katherine Courtney Thompson, M.A.CCC-SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1104156173
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
3600 Angle Ave
Fort Worth, TX 76106
Phone
(817) 624-6164
NPI assigned
Jan 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

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

Addresses

Primary practice location

3600 Angle Ave
Fort Worth, TX 76106

Mailing address

4113 Burwood Dr
Roanoke, TX 76262-3368
Phone (301) 332-3101

Other practice location 1

9601 Interstate 630
Exit 7
Little Rock, AR 72205-7202
Phone (501) 202-1479

Other names 1

  • Katherine Courtney Johnson Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1104156173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 BURWOOD DR",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762623368",
            "telephone_number": "301-332-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 ANGLE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76106",
            "telephone_number": "817-624-6164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9601 Interstate 630",
            "address_2": "Exit 7",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722057202",
            "country_code": "US",
            "telephone_number": "501-202-1479",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KATHERINE",
        "middle_name": "COURTNEY",
        "name_prefix": "Mrs.",
        "credential": "M.A.CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-13",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "JOHNSON",
            "middle_name": "COURTNEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

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

Verify at the official NPI Registry.