Active NPI
Erik Johnson
- Speech-Language Pathologist
- Rockford, IL
National Provider Identifier
1629684220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146014841
- Practice address
- 2990 N Perryville Rd Unit 1100
Rockford, IL 61107-6827 - Phone
- (815) 469-1500
- NPI assigned
- Sep 18, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 146014841 | IL | Primary |
Addresses
Primary practice location
2990 N Perryville Rd Unit 1100
Rockford, IL 61107-6827
Mailing address
2990 N Perryville Rd Unit 1100
Rockford, IL 61107-6827
Phone (815) 469-1500
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146014841 | IL | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Westside Childrens Therapy | Speech-Language Pathologist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1629684220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2990 N PERRYVILLE RD UNIT 1100",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076827",
"telephone_number": "815-469-1500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2990 N PERRYVILLE RD UNIT 1100",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611076827",
"telephone_number": "815-469-1500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ERIK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-09-18",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146014841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.