Individual provider Active NPI

Mark F Johnson, MS, CCC-SLP

  • Speech-Language Pathologist
  • New Port Richey, FL
National Provider Identifier
1639419948
Registry record updated Feb 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SA8062 Issued in FL
Practice address
7400 Trouble Creek Rd
New Port Richey, FL 34653-5642
Phone
(727) 375-2999
Fax
(727) 569-1667
NPI assigned
Feb 22, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2013

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 SA8062 FL Primary

Addresses

Primary practice location

7400 Trouble Creek Rd
New Port Richey, FL 34653-5642

Mailing address

2957 Winglewood Cir
Lutz, FL 33558-5036

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241022005172 FL Practitioner - Qualified Speech Language Pathologist 5395278899 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
SA8062FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC CurrentSince Oct 15, 2024 Accepting new patients
Empowerme Rehabilitation Florida, LLC Speech-Language Pathologist CurrentSince Oct 15, 2024 Accepting new patients

Locations

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

Organizations & group practices 2

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": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361491200000",
    "number": "1639419948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2957 WINGLEWOOD CIR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335585036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 TROUBLE CREEK RD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346535642",
            "telephone_number": "727-375-2999",
            "fax_number": "727-569-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "F",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-22",
        "last_updated": "2013-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Port Richey, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.