Active NPI
Virginia Johnson, SPEECH THERAPIST
- Speech-Language Pathologist
- Longview, TX
National Provider Identifier
1962670638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 19258
- Practice address
- 107 Woodbine PL
Unit 775
Longview, TX 75601-2912 - Phone
- (900) 391-8580
- Fax
- (903) 295-5803
- NPI assigned
- Feb 15, 2008
- Last updated
- Feb 15, 2008
- Sex
- Female
- 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 | 19258 | TX | Primary |
Addresses
Primary practice location
107 Woodbine PL
Unit 775
Longview, TX 75601-2912
Mailing address
2300 Bill Owens Pkwy Apt 322
Longview, TX 75604-3069
Phone (903) 918-5806
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 |
|---|---|---|---|
| 19258 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sabine Valley Regional MHMR Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1962670638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2300 BILL OWENS PKWY APT 322",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756043069",
"telephone_number": "903-918-5806",
"fax_number": "903-295-5803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 WOODBINE PL",
"address_2": "UNIT 775",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756012912",
"telephone_number": "900-391-8580",
"fax_number": "903-295-5803"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "VIRGINIA",
"credential": "SPEECH THERAPIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-15",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "19258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.