Active NPI
Kenneth T Johnson, LMFT
- Marriage & Family Therapist
- Wichita, KS
National Provider Identifier
1679785265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 781
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 781 | KS | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soma Recovery LLC | Marriage & Family Therapist | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.