Individual provider Active NPI

Kathryn Campbell Hanna, MS CCC-SLP

  • Speech-Language Pathologist
  • Johnson City, NY
National Provider Identifier
1336737329
Registry record updated Jan 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
030425 Issued in NY
Practice address
24 Cherry St
Johnson City, NY 13790-2615
Phone
(607) 723-8313
NPI assigned
Jan 5, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2021

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 030425 NY Primary

Addresses

Primary practice location

24 Cherry St
Johnson City, NY 13790-2615

Mailing address

741 Echo Rd
Vestal, NY 13850-5207

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

LicenseStateTypeSpecialty
030425NYMDPharmacotherapy Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Development Council PastSince Jan 10, 2021 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": "1609804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609804800000",
    "number": "1336737329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 ECHO RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138505207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CHERRY ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902615",
            "telephone_number": "607-723-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "KATHRYN",
        "middle_name": "CAMPBELL",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "030425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.

Verify at the official NPI Registry.