Judy Helen Johnson, PH.D.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2005023175 Issued in MO

Practice address

1304 Cottage Lane Ave
Kirksville, MO 63501-4510

Phone

(708) 710-0310

NPI assigned

Jun 4, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1215163290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 COTTAGE LANE AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014510",
            "telephone_number": "708-710-0310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 COTTAGE LANE AVE",
            "city": "KIRKSVILLE",
            "state": "MO",
            "postal_code": "635014510",
            "telephone_number": "708-710-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JUDY",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-04",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146004725",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MO",
            "license": "2005023175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Mingyeong Jeong
• Marcus Jessen
• Job Connection Services, LLC
• Rebecca L Johnaon, SPEECH AND LANGUAGE
• Jeremy Allen Johnson, DPT
• Valerie Johnson
• Travis Johnston, PHARMD
• Christeena Jojo
• Cindy K Jones, LPN
• Tisha R Jones, DDS

• Speech-Language Pathologist in Kirksville, MO
• Providers in Kirksville, MO by specialty
• Speech-Language Pathologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.