Individual provider Active NPI

Breana Johnson

  • Speech-Language Pathologist
  • Bellevue, NE
National Provider Identifier
1215560941
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
749 Issued in NE
Practice address
2908 Vandenberg Ave
Bellevue, NE 68123-1604
Phone
(402) 293-4795
NPI assigned
Feb 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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 749 NE Primary

Addresses

Primary practice location

2908 Vandenberg Ave
Bellevue, NE 68123-1604

Mailing address

2908 Vandenberg Ave
Bellevue, NE 68123-1604

Other practice location 1

17818 Hartman Ave
Omaha, NE 68116-3804
Phone (402) 714-3186

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
2509NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Remain Safe at Home PastSince Jun 29, 2025 Accepting new patients

Organizations & group practices 1

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": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1215560941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2908 VANDENBERG AVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2908 VANDENBERG AVE",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681231604",
            "telephone_number": "402-293-4795"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17818 Hartman Ave",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681163804",
            "country_code": "US",
            "telephone_number": "402-714-3186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BREANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2025; 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.