Robin Johnson

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

1312561 Issued in MS

Practice address

905 School St
Clarksdale, MS 38614-3721

Phone

(662) 351-4668

NPI assigned

Dec 17, 2021

Last updated

Dec 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1073273033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 SCHOOL ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143721",
            "telephone_number": "662-351-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 SCHOOL ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386143721",
            "telephone_number": "662-351-4668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MS",
            "license": "1312561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "621610",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christina Jacobs, LMSW
• Ghanapati Vinil Jambula, M.D
• James Wilkes Bradham Inc (Right at Home of North Ms)
• Ina Jemerson
• Melanie Johnson, RN
• Shana Johnson, M.S.
• Amber Jones, M.ED.
• Anna C. Jones, FNP-C
• Jacqueline Denise Jones, M.S.
• Lela Mae Jones, MSW

• Intellectual & Developmental Disabilities Psychologist in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Intellectual & Developmental Disabilities Psychologist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.