Tara Renee Johnson, M.S., CCC/SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

7970 Issued in NC

Practice address

1995 E Cornelius Harnett Blvd
Lillington, NC 27546-8276

Phone

(919) 800-7445

Fax

(919) 814-0890

NPI assigned

Apr 25, 2008

Last updated

May 4, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Qualified Speech Language Pathologist

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Paragon Outpatient Rehabilitation Services LLCGroup PAC ID 8022272848, 199 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Paragon Outpatient Rehabilitation Services, LLC

  dba Synchrony Rehabilitation

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1871867325

  NC

  Medicare reassignment Care Compare group NPD
• Paragon Outpatient Rehabilitation Services, LLC

  dba Synchrony Rehab

  • Rehabilitation Clinic/Center
  • Roxboro, NC
  • NPI 1245014380
  NPD

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272931200000",
    "number": "1770758286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 E CORNELIUS HARNETT BLVD",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275468276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 E CORNELIUS HARNETT BLVD",
            "city": "LILLINGTON",
            "state": "NC",
            "postal_code": "275468276",
            "telephone_number": "919-800-7445",
            "fax_number": "919-814-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TARA",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC/SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2010-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "7970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Pulido Jeffries, RPH
• Kaneesha Bonita Jenrette, LMBT
• JKM Community Services, PLLC
• Amanda Hiester Johnson, PHARMD
• Nikole Johnson, LCSW
• Tiy Johnson, PA-C
• Cynthia Lachmann Johnston, FNP
• Manavi Johri
• Maggie Jones
• Akaninyene Joseph

• Speech-Language Pathologist in Lillington, NC
• Providers in Lillington, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.