Individual provider Active NPI

Katandria Johnson, DRPH

  • Speech-Language Pathologist
  • Cedar Hill, TX
National Provider Identifier
1790135200
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
101206 Issued in NU
Practice address
400 Bluff CT
Cedar Hill, TX 75104-6726
Phone
(817) 825-4001
Fax
(817) 288-0650
NPI assigned
Jun 15, 2016
Last updated
Jun 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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 101206 NU Primary

Addresses

Primary practice location

400 Bluff CT
Cedar Hill, TX 75104-6726

Mailing address

400 Bluff CT
Cedar Hill, TX 75104-6726

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

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1790135200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BLUFF CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BLUFF CT",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751046726",
            "telephone_number": "817-825-4001",
            "fax_number": "817-288-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KATANDRIA",
        "name_prefix": "Dr.",
        "credential": "DRPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": "101206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Hill, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.