Individual provider Active NPI

Elizabeth Kahrs Johanson

  • Speech-Language Pathologist
  • Hickory, NC
National Provider Identifier
1194383919
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
11222 Issued in NC
Practice address
858 2ND St NE Ste 101
Hickory, NC 28601-3878
Phone
(828) 322-7826
NPI assigned
Jun 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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 11222 NC Primary

Addresses

Primary practice location

858 2ND St NE Ste 101
Hickory, NC 28601-3878

Mailing address

5879 McClintock Dr
Denver, NC 28037-0198
Phone (704) 975-2051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231109000945 NC Practitioner - Qualified Speech Language Pathologist 6608223888 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Speech Therapy Inc Speech-Language Pathologist CurrentSince Dec 1, 2023 Accepting new patients
Tidal Therapy Solutions LLC Speech-Language Pathologist CurrentSince Aug 8, 2024 Accepting new patients
Eastern Therapy Solutions, PLLC Speech-Language Pathologist CurrentSince Feb 17, 2025 Accepting new patients

Locations

124 E Park Dr
Beulaville, NC 28518
Phone (888) 258-6905

2761 NC Highway 210 E
Ste G
Hampstead, NC 28443
Phone (775) 481-7908

9020 Senca Dr
Ste 220
Wilmington, NC 28411
Phone (910) 264-9317

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1194383919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5879 MCCLINTOCK DR",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280370198",
            "telephone_number": "704-975-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "858 2ND ST NE STE 101",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013878",
            "telephone_number": "828-322-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSON",
        "first_name": "ELIZABETH",
        "middle_name": "KAHRS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-05",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.