Individual provider Active NPI

Mary K Johnston, SLP

  • Speech-Language Pathologist
  • Kansas City, KS
National Provider Identifier
1124136544
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
186 Issued in KS
Practice address
3901 Rainbow Blvd MSC 4043
2032 School of Nursing
Kansas City, KS 66160-0001
Phone
(866) 249-9736
NPI assigned
Aug 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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 100112 MO
Speech-Language Pathologist 235Z00000X 186 KS Primary

Addresses

Primary practice location

3901 Rainbow Blvd MSC 4043
2032 School of Nursing
Kansas City, KS 66160-0001

Mailing address

PO Box 307
Stilwell, KS 66085-0307
Phone (913) 522-4894

Other identifiers 1

IdentifierTypeStateIssuer
29541028OtherBCBS PROVIDER NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
100112MOMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1156550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1124136544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "STILWELL",
            "state": "KS",
            "postal_code": "660850307",
            "telephone_number": "913-522-4894",
            "fax_number": "713-344-9420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 RAINBOW BLVD MSC 4043",
            "address_2": "2032 SCHOOL OF NURSING",
            "city": "KANSAS CITY",
            "state": "KS",
            "postal_code": "661600001",
            "telephone_number": "866-249-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "MARY",
        "middle_name": "K",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-26",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "100112",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "KS",
            "license": "186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "29541028",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.