Lisa M Johnson, M.A. CCC/SLP/L

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.004910 Issued in IL

Practice address

3520 Kishwaukee St
Rockford, IL 61109-2005

Phone

(815) 229-2870

NPI assigned

Nov 27, 2017

Last updated

Nov 27, 2017By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1558875799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7875 TODD RD",
            "city": "SHABBONA",
            "state": "IL",
            "postal_code": "605504162",
            "telephone_number": "815-824-8152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3520 KISHWAUKEE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611092005",
            "telephone_number": "815-229-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "M",
        "credential": "M.A. CCC/SLP/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.004910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146.004910",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey James Johnson, D.D.S.
• Jenifer E. Johnson
• Justin William Johnson, O.D.
• Kai Johnson, LCPC
• Leo C Johnson, PA-C
• Megan Johnson, LCPC
• Michele Dawn Johnson, APN
• Morgan Johnson
• Nadene Johnson, L.M.T., M.M.P.
• Nadia Johnson

• Speech-Language Pathologist in Rockford, IL
• Providers in Rockford, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.