Fundamental Kids Therapy LLC
NPI 1922443522ActiveOrganization· Speech-Language Pathologist· Shoreview, MN
Speech-Language Pathologist in Shoreview, Minnesota, registered in NPPES in May 2013. The authorized official on file is Julie M. Johnson, MA, CCC-SLP, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1922443522 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 8, 2013 |
| Last updated in NPPES | Oct 17, 2021 |
| Certified by provider | Oct 17, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Speech-Language Pathologist Primary | 235Z00000X | 8614 | MN |
| Occupational Therapist | 225X00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MN) |
|---|
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