Active NPI
Matthew Johnson, MA CCC-SLP
- Speech-Language Pathologist
- Gallipolis, OH
National Provider Identifier
1861866329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SP.11359
- Practice address
- 170 Pinecrest Dr
Gallipolis, OH 45631-1347 - Phone
- (740) 446-7112
- Fax
- (740) 441-9088
- NPI assigned
- Nov 20, 2015
- 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 | SP.11359 | OH | Primary |
Addresses
Primary practice location
170 Pinecrest Dr
Gallipolis, OH 45631-1347
Mailing address
170 Pinecrest Dr
Gallipolis, OH 45631-1347
Phone (740) 446-7112
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP.11359 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447977600000",
"number": "1861866329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-446-7112",
"fax_number": "740-441-9088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 PINECREST DR",
"city": "GALLIPOLIS",
"state": "OH",
"postal_code": "456311347",
"telephone_number": "740-446-7112",
"fax_number": "740-441-9088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-11-20",
"last_updated": "2015-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "OH",
"license": "SP.11359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallipolis, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.