Active NPI
Mary Katherine Johnson, MS, CCC-SLP
- Speech-Language Pathologist
- Quincy, MA
National Provider Identifier
1285116624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 77343-SP-SL
- Practice address
- 2 Moon Island Rd
Quincy, MA 02171 - Phone
- (781) 864-9049
- NPI assigned
- Sep 2, 2018
- Last updated
- May 6, 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 | 77343-SP-SL | MA | Primary |
Addresses
Primary practice location
2 Moon Island Rd
Quincy, MA 02171
Mailing address
60 Pheasant Hill Rd
South Weymouth, MA 02190
Phone (781) 864-9049
Other practice location 1
163 Libbey Industrial Pkwy
Weymouth, MA 02189-3137
Phone (781) 335-6663
Other names 1
- Mary Katherine Mackenzie
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77343-SP-SL | MA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Shore Therapies | Speech-Language Pathologist | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Speech-Language Pathologist
- Weymouth, MA
- NPI 1316004179
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620259200000",
"number": "1285116624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 PHEASANT HILL RD",
"city": "SOUTH WEYMOUTH",
"state": "MA",
"postal_code": "02190",
"telephone_number": "781-864-9049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MOON ISLAND RD",
"city": "QUINCY",
"state": "MA",
"postal_code": "02171",
"telephone_number": "781-864-9049"
}
],
"practiceLocations": [
{
"address_1": "163 Libbey Industrial Pkwy",
"address_purpose": "LOCATION",
"city": "Weymouth",
"state": "MA",
"postal_code": "021893137",
"country_code": "US",
"telephone_number": "781-335-6663",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARY",
"middle_name": "KATHERINE",
"credential": "MS, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-02",
"last_updated": "2021-05-06",
"certification_date": "2021-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MA",
"license": "77343-SP-SL",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARY",
"last_name": "MACKENZIE",
"middle_name": "KATHERINE",
"credential": "MS, CCC-SLP",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Quincy, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.