Kelly Johnston

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA7185 Issued in FL

Practice address

16 Black Water Way
Ormond Beach, FL 32174-5706

Phone

(386) 871-0428

Fax

(386) 673-9569

NPI assigned

Jun 20, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Pediatric Therapy of Ormond, LLC

  • Physical Therapist
  • Ormond Beach, FL
  • NPI 1568646008

  Speech-Language Pathologist

  NPD (past)
• Pediatric Therapy of Ormond, LLC

  • Early Intervention Provider Agency
  • Ormond Beach, FL
  • NPI 1679227508
  NPD (past)

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1396195368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BLACK WATER WAY",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BLACK WATER WAY",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745706",
            "telephone_number": "386-871-0428",
            "fax_number": "386-673-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "KELLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald Charles Johnson Jr., DPM
• Erica Lynn Johnson, PHARMD
• Jacqueline L Johnson
• Vivianne Johnson
• Joseph D Johnston, PT
• Michelle B Johnston, PA
• Stephanie Johnston, COTA/L
• Chloe Marie Jones Spiker
• Doris Jane Jones, ARNP
• Gordon Jones, M.D.

• Speech-Language Pathologist in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.