Mary Johannes

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

10171 Issued in MN

Practice address

2101 Wooddale Dr Ste a
Woodbury, MN 55125-2933

Phone

(651) 738-9888

NPI assigned

Aug 31, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Family Achievement Center Inc.

  • Occupational Therapist
  • Woodbury, MN
  • NPI 1952411175
  Medicare reassignment

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1679055149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 WOODDALE DR STE A",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252933",
            "telephone_number": "651-738-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNES",
        "first_name": "MARY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MN",
            "license": "10171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachael Jerabek, OTD, OTR/L
• Hanah Jesz, MA, LMFT
• Jose Manuel Jimenez Vega, M.D.
• Abigail R Jing, DPT
• Karen Jiran-Salls, PT, PRC
• James A Johanning, PA-C
• Justin Thomas Johnsen, PA-C
• Adam C Johnson, DPT
• Amanda K Johnson, DNP, APNP
• Amanda Marie Johnson, MA, LPCC

• Speech-Language Pathologist in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.