Brian R Johnson, S.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

LL00003248 Issued in WA

Practice address

626 120TH Ave NE
Suite B201
Bellevue, WA 98005-3077

Phone

(425) 556-6330

Fax

(425) 556-6325

NPI assigned

Feb 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment NPD

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1104964188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "address_2": "BELLEVUE MEDICAL CENTER",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3898",
            "fax_number": "425-502-4233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "626 120TH AVE NE",
            "address_2": "SUITE B201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980053077",
            "telephone_number": "425-556-6330",
            "fax_number": "425-556-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "S.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL00003248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8410839",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aleesha Johnson
• Amanda Margaret Johnson
• Ann Johnson, PT
• Barbara Johnson, MA LMFT
• Bradley Allen Johnson, CRNA
• Carlyn Johnson
• Christopher Darren Johnson, MPT
• Clyde W Johnson, PT, CHT
• Cynthia Pipes Johnson, LMP
• Elaine Johnson, CP00005772

• Speech-Language Pathologist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Speech-Language Pathologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.