Active NPI
Beth A Johnson, MA CCC SLP L
- Speech-Language Pathologist
- Champaign, IL
National Provider Identifier
1740440874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 146007061
- Practice address
- 201 W Springfield Ave Ste 702
Champaign, IL 61820-4845 - Phone
- (217) 215-3016
- Fax
- (217) 215-3016
- NPI assigned
- Jun 12, 2008
- Sex
- Female
- 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 | 146007061 | IL | Primary |
Addresses
Primary practice location
201 W Springfield Ave Ste 702
Champaign, IL 61820-4845
Mailing address
201 W Springfield Ave Ste 702
Champaign, IL 61820-4845
Phone (217) 215-3016
Other practice location 1
810 W Anthony Dr
Urbana, IL 61801
Phone (217) 326-2911
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 203 | Other | IL | BLUE CROSS |
| 7216 | Other | IL | PERSONAL CARE |
| 113326 | Other | IL | HEALTHLINK |
| 4117 | Other | IL | HEALTH ALLIANCE |
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146007061 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674864000000",
"number": "1740440874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 W SPRINGFIELD AVE STE 702",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618204845",
"telephone_number": "217-215-3016",
"fax_number": "217-215-3016"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 W SPRINGFIELD AVE STE 702",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618204845",
"telephone_number": "217-215-3016",
"fax_number": "217-215-3016"
}
],
"practiceLocations": [
{
"address_1": "810 W Anthony Dr",
"address_purpose": "LOCATION",
"city": "Urbana",
"state": "IL",
"postal_code": "61801",
"country_code": "US",
"telephone_number": "217-326-2911",
"fax_number": "217-344-8047",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "BETH",
"middle_name": "A",
"credential": "MA CCC SLP L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-12",
"last_updated": "2023-01-28",
"certification_date": "2023-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146007061",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "203",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PERSONAL CARE",
"identifier": "7216",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "113326",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH ALLIANCE",
"identifier": "4117",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.