Individual provider Active NPI

Tara Johnson, MS, CCC -SLP

  • Speech-Language Pathologist
  • Lowell, MA
National Provider Identifier
1508119488
Registry record updated Oct 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7688 Issued in MA
Practice address
1 Hospital Dr
Speech Pathology: LGH, Saints Campus
Lowell, MA 01852-1311
Phone
(978) 934-8236
NPI assigned
Oct 17, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2012

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 7688 MA Primary

Addresses

Primary practice location

1 Hospital Dr
Speech Pathology: LGH, Saints Campus
Lowell, MA 01852-1311

Mailing address

1 Hospital Dr
Speech Pathology: LGH, Saints Campus
Lowell, MA 01852-1311

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
7688MAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350432000000",
    "number": "1508119488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SPEECH PATHOLOGY: LGH, SAINTS CAMPUS",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOSPITAL DR",
            "address_2": "SPEECH PATHOLOGY: LGH, SAINTS CAMPUS",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521311",
            "telephone_number": "978-934-8236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TARA",
        "name_prefix": "Ms.",
        "credential": "MS, CCC -SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "7688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2012; 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.