Kentrell Johnson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

24359864 Issued in OK

Practice address

8007 NW 122ND St
Oklahoma City, OK 73142-3302

Phone

(405) 603-6622

NPI assigned

Jul 26, 2024

Sex

Male

Sole proprietor

No

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

Locations

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.

• Speech Pathway LLC

  • Speech-Language Pathologist
  • Oklahoma City, OK
  • NPI 1659637148
  NPD
• Speech Pathways, PLLC

  • Rehabilitation Clinic/Center
  • Ardmore, OK
  • NPI 1053361741
  NPD (past)

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

{
    "created_epoch": "1721952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1558199810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 S ARIES RD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730035821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 NW 122ND ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731423302",
            "telephone_number": "405-603-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENTRELL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-26",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OK",
            "license": "24359864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine Elzabeth Johnson, RBT
• Kathryn Johnson, DO
• Kayrine Johnson
• Kelly Nicole Johnson, M.S., LMFT
• Kent Alan Johnson, NP
• Kenyon Johnson
• Kia Johnson
• Kimberly Johnson
• Kurstan Johnson
• Kyle Johnson

• All providers in Oklahoma City, OK
• Behavior Analyst in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.