Active NPI
Caroline Elizabeth Johnson
- Speech-Language Pathologist
- Dallas, TX
National Provider Identifier
1902380157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 115118
- Practice address
- 419 W Pembroke Ave
Dallas, TX 75208-6535 - Phone
- (512) 297-5955
- NPI assigned
- Sep 23, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 115118 | TX | Primary |
Addresses
Primary practice location
419 W Pembroke Ave
Dallas, TX 75208-6535
Mailing address
4717 Twin Valley Dr
Austin, TX 78731-3536
Phone (512) 297-5955
Other practice location 1
326 E 12th St
Dallas, TX 75203-2606
Phone (512) 297-5955
Other practice location 2
3020 N Westmoreland Rd
Dallas, TX 75212-3647
Phone (512) 297-5955
Other practice location 3
2200 E Ledbetter Dr
Dallas, TX 75216-7408
Phone (512) 297-5955
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 115118 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537660800000",
"number": "1902380157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4717 TWIN VALLEY DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787313536",
"telephone_number": "512-297-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "419 W PEMBROKE AVE",
"city": "DALLAS",
"state": "TX",
"postal_code": "752086535",
"telephone_number": "512-297-5955"
}
],
"practiceLocations": [
{
"address_1": "326 E 12th St",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752032606",
"country_code": "US",
"telephone_number": "512-297-5955",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3020 N Westmoreland Rd",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752123647",
"country_code": "US",
"telephone_number": "512-297-5955",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2200 E Ledbetter Dr",
"address_purpose": "LOCATION",
"city": "Dallas",
"state": "TX",
"postal_code": "752167408",
"country_code": "US",
"telephone_number": "512-297-5955",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "CAROLINE",
"middle_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-23",
"last_updated": "2018-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "115118",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.