Individual provider Active NPI

Sarah Kathleen Humphreys Johnson

  • Speech-Language Pathologist
  • Tyler, TX
National Provider Identifier
1952823452
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
113627 Issued in TX
Practice address
100 E Ferguson St
Tyler, TX 75702-5759
Phone
(903) 509-2040
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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 113627 TX Primary

Addresses

Primary practice location

100 E Ferguson St
Tyler, TX 75702-5759

Mailing address

4123 Southpark Dr Apt 131
Tyler, TX 75703-1847
Phone (903) 522-1385

Other names 1

  • Sarah Kathleen Johnson Professional name

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

LicenseStateTypeSpecialty
113627TXMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1952823452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4123 SOUTHPARK DR APT 131",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031847",
            "telephone_number": "903-522-1385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E FERGUSON ST",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757025759",
            "telephone_number": "903-509-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS JOHNSON",
        "first_name": "SARAH",
        "middle_name": "KATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "113627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "JOHNSON",
            "middle_name": "KATHLEEN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2017; 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.