Kierstyn Johnson-Wigfall

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2202006559 Issued in VA

Practice address

13900 Hull Street Rd
Midlothian, VA 23112-2004

Phone

(804) 639-8788

NPI assigned

Mar 7, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Functional Pathways Preferred of Tennessee LLC

  • Physical Therapist
  • Knoxville, TN
  • NPI 1841561446

  Speech-Language Pathologist

  NPD

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1932569712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 IRON BRIDGE RD",
            "city": "CHESTER",
            "state": "VA",
            "postal_code": "238311460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13900 HULL STREET RD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122004",
            "telephone_number": "804-639-8788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12001 Iron Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Chester",
            "state": "VA",
            "postal_code": "238311460",
            "country_code": "US",
            "telephone_number": "804-413-6508",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON-WIGFALL",
        "first_name": "KIERSTYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202006559",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932569712",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Mathews LCSW, LLC
• John S. Peery Optometrist P.C.
• Angela Johns
• Mark E Johns, MD
• Tracey Denise Johnson-King, LPC-R
• Daniel Logan Johnson
• Diane Lee Johnson, M.D., A.A.F.P.
• Lesley C Johnson, DPT
• Wendy White Johnson
• Anna Johnston

• Speech-Language Pathologist in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Speech-Language Pathologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.

Verify at the official NPI Registry.