Individual provider Active NPI

Abby Michele Johnson, MS, CFY-SLP

  • Speech-Language Pathologist
  • Atlantic, IA
National Provider Identifier
1902263965
Registry record updated Jun 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
095620 Issued in IA
Practice address
1501 E 10TH St
Atlantic, IA 50022-1936
Phone
(712) 249-5103
NPI assigned
Jan 21, 2016
Last updated
Jun 5, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 095620 IA Primary
Behavior Analyst 103K00000X NU

Addresses

Primary practice location

1501 E 10TH St
Atlantic, IA 50022-1936

Mailing address

1501 E 10TH St
Atlantic, IA 50022-1936
Phone (712) 249-5103

Other practice location 1

9012 Q St
Omaha, NE 68127-3549
Phone (402) 315-1000 ext. 172

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 Science

State licenses

LicenseStateTypeSpecialty
095620IAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1453334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1902263965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-249-5103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E 10TH ST",
            "city": "ATLANTIC",
            "state": "IA",
            "postal_code": "500221936",
            "telephone_number": "712-249-5103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9012 Q St",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681273549",
            "country_code": "US",
            "telephone_number": "402-315-1000 x172",
            "fax_number": "402-559-5737",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ABBY",
        "middle_name": "MICHELE",
        "credential": "MS, CFY-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-21",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "095620",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlantic, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.