Active NPI
Laura Lynn Mettler, M.A.
- Speech-Language Pathologist
- Norfolk, NE
National Provider Identifier
1497073670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 479
- Practice address
- 2404 Taylor Ave
Norfolk, NE 68701-4646 - Phone
- (402) 379-0505
- Fax
- (402) 379-0555
- NPI assigned
- May 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 | 479 | NE | Primary |
Addresses
Primary practice location
2404 Taylor Ave
Norfolk, NE 68701-4646
Mailing address
2404 Taylor Ave
Norfolk, NE 68701-4646
Phone (402) 379-0505
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 479 | Other | NE | SPEECH-LANGUAGE PATHOLOGIST LICENSE |
Other names 1
- Miss Laura Lynn Johnson
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 479 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273622400000",
"number": "1497073670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2404 TAYLOR AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014646",
"telephone_number": "402-379-0505",
"fax_number": "402-379-0555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2404 TAYLOR AVE",
"city": "NORFOLK",
"state": "NE",
"postal_code": "687014646",
"telephone_number": "402-379-0505",
"fax_number": "402-379-0555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METTLER",
"first_name": "LAURA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-12",
"last_updated": "2010-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NE",
"license": "479",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SPEECH-LANGUAGE PATHOLOGIST LICENSE",
"identifier": "479",
"state": "NE"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAURA",
"last_name": "JOHNSON",
"middle_name": "LYNN",
"prefix": "MISS",
"credential": "M.A.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Norfolk, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.