Active NPI
Johanna Poertner, MS., CCC-SLP
- Speech-Language Pathologist
- Gilbert, AZ
National Provider Identifier
1972329753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- SLP14665
- Practice address
- 1519 S Higley Rd
Gilbert, AZ 85296-4793 - Phone
- (480) 608-2781
- NPI assigned
- Nov 26, 2024
- 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 | SLP14665 | AZ | Primary |
Addresses
Primary practice location
1519 S Higley Rd
Gilbert, AZ 85296-4793
Mailing address
4727 W Rosewood Dr
Glendale, AZ 85304-2059
Phone (602) 743-6741
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
| License | State | Type | Specialty |
|---|---|---|---|
| SLP14665 | AZ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soar Health, Inc. | Speech-Language Pathologist | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732579200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732579200000",
"number": "1972329753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4727 W ROSEWOOD DR",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853042059",
"telephone_number": "602-743-6741"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1519 S HIGLEY RD",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852964793",
"telephone_number": "480-608-2781"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POERTNER",
"first_name": "JOHANNA",
"credential": "MS., CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-26",
"last_updated": "2024-11-26",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "AZ",
"license": "SLP14665",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.