Active NPI
Kiana Johnson
- Speech-Language Pathologist
- Fayetteville, NC
National Provider Identifier
1194489013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 14298
- Practice address
- 934 Cambridge St
Fayetteville, NC 28303-5300 - Phone
- (910) 929-6148
- Fax
- (910) 493-3520
- NPI assigned
- Oct 27, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 14298 | NC | Primary |
Addresses
Primary practice location
934 Cambridge St
Fayetteville, NC 28303-5300
Mailing address
934 Cambridge St
Fayetteville, NC 28303-5300
Phone (910) 929-6148
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221213003400 | NC | Practitioner - Qualified Speech Language Pathologist | 6800265869 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14298 | NC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1635292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1194489013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "934 CAMBRIDGE ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283035300",
"telephone_number": "910-929-6148",
"fax_number": "910-493-3520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "934 CAMBRIDGE ST",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283035300",
"telephone_number": "910-929-6148",
"fax_number": "910-493-3520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KIANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-10-27",
"last_updated": "2021-10-27",
"certification_date": "2021-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "14298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.