Active NPI
Russell Johnston, M.A., CCC-SLP
- Speech-Language Pathologist
- Lawrence, KS
National Provider Identifier
1699286617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 3856
- Practice address
- 1200 Sunnyside Ave
Lawrence, KS 66045-7600 - Phone
- (785) 864-4690
- Fax
- (785) 864-5094
- NPI assigned
- Oct 17, 2017
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 3856 | KS | Primary |
Addresses
Primary practice location
1200 Sunnyside Ave
Lawrence, KS 66045-7600
Mailing address
1200 Sunnyside Ave
2101 Haworth Hall
Lawrence, KS 66045
Phone (785) 864-4690
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3856 | Other | KS | KDADS LICENSE |
| 14175399 | Other | MD | ASHA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Watkins Health Services- the Univ of Kansas - Watkins Health Services | Past | Accepting new patients |
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.
-
dba University of Kansas
- Multi-Specialty Clinic/Center
- Lawrence, KS
- NPI 1942357413
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508198400000",
"number": "1699286617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 SUNNYSIDE AVE",
"address_2": "2101 HAWORTH HALL",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "66045",
"telephone_number": "785-864-4690",
"fax_number": "785-864-5094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 SUNNYSIDE AVE",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660457600",
"telephone_number": "785-864-4690",
"fax_number": "785-864-5094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "RUSSELL",
"credential": "M.A., CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-17",
"last_updated": "2017-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KS",
"license": "3856",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KDADS LICENSE",
"identifier": "3856",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA",
"identifier": "14175399",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.