Individual provider Active NPI

Johanna Etts, M.S., CCC-SLP

  • Speech-Language Pathologist
  • Bowling Green, OH
National Provider Identifier
1215857636
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP.16968 Issued in OH
Practice address
710 Kenwood Ave
Bowling Green, OH 43402-3705
Phone
(419) 354-0500
NPI assigned
Jul 16, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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 SP.16968 OH Primary

Addresses

Primary practice location

710 Kenwood Ave
Bowling Green, OH 43402-3705

Mailing address

1867 N Research Dr
Bowling Green, OH 43402-8835

Other practice location 1

1921 E Gypsy Lane Rd
Bowling Green, OH 43402-9396
Phone (419) 352-5115

Other practice location 2

909 Klotz Rd
Bowling Green, OH 43402-4818
Phone (419) 354-9010

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784160000000",
    "number": "1215857636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 N RESEARCH DR",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434028835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 KENWOOD AVE",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434023705",
            "telephone_number": "419-354-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1921 E Gypsy Lane Rd",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "OH",
            "postal_code": "434029396",
            "country_code": "US",
            "telephone_number": "419-352-5115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "909 Klotz Rd",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "OH",
            "postal_code": "434024818",
            "country_code": "US",
            "telephone_number": "419-354-9010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETTS",
        "first_name": "JOHANNA",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OH",
            "license": "SP.16968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.