Individual provider Active NPI

John Allan Ernst, PHD

  • Clinical Neuropsychologist
  • Tacoma, WA
National Provider Identifier
1063624104
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
953 Issued in WA
Practice address
1717 S J St # Ms 02-12
St Joseph Medical Center
Tacoma, WA 98405-4933
Phone
(253) 426-6762
Fax
(253) 426-6224
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 953 WA Primary

Addresses

Primary practice location

1717 S J St # Ms 02-12
St Joseph Medical Center
Tacoma, WA 98405-4933

Mailing address

1717 S J St # Ms 02-12
PO Box 2197, St Joseph Medical Center
Tacoma, WA 98405-4933
Phone (253) 426-6762

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20071011000660 WA Practitioner - Clinical Psychologist 7911093596 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
953WAMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tacoma Psychology, PLLC CurrentSince Jul 8, 2019 Accepting new patients
Franciscan Health System Past Accepting new patients
Franciscan Health System Past Accepting new patients

Locations

1919 N Pearl St
Ste C2
Tacoma, WA 98406
Phone (253) 383-0101

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1063624104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST # MS 02-12",
            "address_2": "PO BOX 2197, ST JOSEPH MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6762",
            "fax_number": "253-426-6224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST # MS 02-12",
            "address_2": "ST JOSEPH MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6762",
            "fax_number": "253-426-6224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNST",
        "first_name": "JOHN",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.