John Johnson Jr.

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

621 W Southern Ave
Mesa, AZ 85210-5004

Phone

(602) 329-3494

Fax

(480) 649-4190

NPI assigned

Nov 10, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Lifewell Behavioral Wellness

  • Mental Illness Community Based Residential Treatment Facility
  • Mesa, AZ
  • NPI 1801976709
  NPD (past)

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1013313600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E EARLL DR",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122647",
            "telephone_number": "602-599-5404",
            "fax_number": "602-599-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 W SOUTHERN AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852105004",
            "telephone_number": "602-329-3494",
            "fax_number": "480-649-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fredrick G. Johnson, C.R.N.F.A.
• Hebert Johnson
• Heidi Johnson
• Jedidiah Johnson, PA-C
• Jennifer Johnson, PHARMD
• Julie Johnson
• Kaitlynn Johnson
• Katherine Grace Johnson
• Kim L. Johnson, PH.D.
• Kord Johnson

• All providers in Mesa, AZ
• Case Manager/Care Coordinator in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.