Heather Irene Johnson, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

621 W Madrone St
Roseburg, OR 97470-3090

Phone

(541) 440-3532

Fax

(541) 440-3554

NPI assigned

Sep 20, 2013

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

Other names 1

• Heather I Cannon Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Adapt

  • Addiction (Substance Use Disorder) Counselor
  • Roseburg, OR
  • NPI 1720010549
  Medicare reassignment NPD
• Adapt

  • Federally Qualified Health Center (FQHC)
  • Bandon, OR
  • NPI 1194529289
  NPD
• Adapt

  • Substance Abuse Rehabilitation Facility
  • Roseburg, OR
  • NPI 1649453440
  NPD
• Adapt

  • Adult Mental Health Clinic/Center
  • Grants Pass, OR
  • NPI 1477250603
  NPD (past)

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

{
    "created_epoch": "1379635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1003242173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W MADRONE ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703090",
            "telephone_number": "541-440-3532",
            "fax_number": "541-440-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEATHER",
        "middle_name": "IRENE",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-20",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500663460",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "CANNON",
            "middle_name": "I",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jessica Brake, LPC, LLC
• Joel R Daven MD PC
• John Wrigley, M.D.,P.C.
• Kristoffer Scott Johns, CCC-SLP
• Alisha Johnson, LMT
• Helen Kathleen Johnson
• Jessica A Johnson, PHARMD
• Marci Ann Johnson
• Mark A Johnson, BS
• Vicki L. Johnson, LPC

• Social Worker in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.