Individual provider Active NPI

Laura Ann Johnson, SLP

  • Speech-Language Pathologist
  • Spencer, IA
National Provider Identifier
1699019323
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
002003 Issued in IA
Practice address
1200 1St Ave E
Spencer, IA 51301-4330
Phone
(712) 264-6415
Fax
(712) 264-6542
NPI assigned
Nov 19, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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 002003 IA Primary

Addresses

Primary practice location

1200 1St Ave E
Spencer, IA 51301-4330

Mailing address

1200 1St Ave E
Spencer, IA 51301-4330
Phone (712) 264-6415

Other names 1

  • Laura Ann Edmonds Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121227000044 IA Practitioner - Qualified Speech Language Pathologist 9335392372 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002003IAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer Municipal Hospital CurrentSince Nov 27, 2012 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients
Spencer Municipal Hospital CurrentSince Nov 27, 2012 Accepting new patients
Spencer Municipal Hospital Current Accepting new patients

Locations

2004 Okoboji Ave
Milford, IA 51351
Phone (712) 338-2461

1200 1st Ave E
Spencer, IA 51301
Phone (712) 264-6164

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450310400000",
    "number": "1699019323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014330",
            "telephone_number": "712-264-6415",
            "fax_number": "712-264-6542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 1ST AVE E",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014330",
            "telephone_number": "712-264-6415",
            "fax_number": "712-264-6542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2015-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "002003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "EDMONDS",
            "middle_name": "ANN",
            "credential": "SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.