Individual provider Active NPI

Kenneth T Johnson, LMFT

  • Marriage & Family Therapist
  • Wichita, KS
National Provider Identifier
1679785265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
781 Issued in KS
Practice address
560 N Exposition
Wichita, KS 67203
Phone
(316) 264-8317
Fax
(316) 264-0347
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 781 KS Primary

Addresses

Primary practice location

560 N Exposition
Wichita, KS 67203

Mailing address

337 N Armour St
Wichita, KS 67206-2030
Phone (316) 854-0112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250116000558 KS Practitioner - Clinical Social Worker 0840728044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soma Recovery LLCGroup PAC ID 7810387339, 31 clinicians

Practice addresses (Care Compare)

825 N Waco Ave
Wichita, KS 67203-3939
Phone (316) 201-6047

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
781KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Recovery LLC Marriage & Family Therapist CurrentSince Jan 8, 2025 Accepting new patients

Locations

825 N Waco Ave
Wichita, KS 67203
Phone (316) 201-6047

825 N Waco Ave
Ste 200
Wichita, KS 67203
Phone (316) 201-6047

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679785265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "337 N ARMOUR ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672062030",
            "telephone_number": "316-854-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 N EXPOSITION",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "67203",
            "telephone_number": "316-264-8317",
            "fax_number": "316-264-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENNETH",
        "middle_name": "T",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.