Active NPI
Derek W. Johnson
- Addiction (Substance Use Disorder) Counselor
- Hyannis, MA
National Provider Identifier
1013443563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 29 Bassett LN
Hyannis, MA 02601-3813 - Phone
- (774) 810-5062
- NPI assigned
- May 3, 2017
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | MA | Primary |
Addresses
Primary practice location
29 Bassett LN
Hyannis, MA 02601-3813
Mailing address
69 Emerald Lane
Marstons Mills, MA 02648
Phone (774) 810-5062
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493769600000",
"number": "1013443563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "69 EMERALD LANE",
"city": "MARSTONS MILLS",
"state": "MA",
"postal_code": "02648",
"telephone_number": "774-810-5062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29 BASSETT LN",
"city": "HYANNIS",
"state": "MA",
"postal_code": "026013813",
"telephone_number": "774-810-5062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "DEREK",
"middle_name": "W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-03",
"last_updated": "2017-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hyannis, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.