Individual provider Active NPI

Katherine Anne Johnson, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Chesterfield, MO
National Provider Identifier
1205477825
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2019023595 Issued in MO
Practice address
224 S Woods Mill Rd Ste 640S
Chesterfield, MO 63017-3617
Phone
(314) 970-6335
Fax
(314) 268-4028
NPI assigned
Oct 4, 2019
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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 2019023595 MO Primary
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

224 S Woods Mill Rd Ste 640S
Chesterfield, MO 63017-3617

Mailing address

224 S Woods Mill Rd Ste 640S
Chesterfield, MO 63017-3617
Phone (314) 970-6335

Other practice location 1

3800 Park Ave Fl 2
Saint Louis, MO 63110-2514
Phone (314) 577-5609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250317001843 MO Practitioner - Qualified Speech Language Pathologist 8628590957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Cardinal Glennon Childrens Hospital CurrentSince Jan 6, 2025 Accepting new patients
SSM Cardinal Glennon Children's Hospital CurrentSince Jan 6, 2025 Accepting new patients
Wentzville School District PastSince Oct 21, 2025 Accepting new patients

Locations

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

3800 Park Ave
Fl 2
Saint Louis, MO 63110
Phone (314) 577-5609

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1570147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1205477825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 640S",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173617",
            "telephone_number": "314-970-6335",
            "fax_number": "314-268-4028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 S WOODS MILL RD STE 640S",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173617",
            "telephone_number": "314-970-6335",
            "fax_number": "314-268-4028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Park Ave Fl 2",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631102514",
            "country_code": "US",
            "telephone_number": "314-577-5609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATHERINE",
        "middle_name": "ANNE",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-04",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2019023595",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.