Active NPI
Amber M Johnson
- Clinical Social Worker
- Lexington, KY
National Provider Identifier
1053077982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 256233
- Practice address
- 90 Southport Dr
Lexington, KY 40503-1819 - Phone
- (859) 288-7580
- Fax
- (859) 373-8033
- NPI assigned
- Nov 15, 2021
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 256233 | KY | Primary |
Addresses
Primary practice location
90 Southport Dr
Lexington, KY 40503-1819
Mailing address
90 Southport Dr
Lexington, KY 40503-1819
Phone (859) 288-7580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2024 through Oct 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 256233 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1636934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636934400000",
"number": "1053077982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 SOUTHPORT DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031819",
"telephone_number": "859-288-7580",
"fax_number": "859-373-8033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 SOUTHPORT DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031819",
"telephone_number": "859-288-7580",
"fax_number": "859-373-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "AMBER",
"middle_name": "M",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-15",
"last_updated": "2021-11-15",
"certification_date": "2021-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KY",
"license": "256233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.