Active NPI
Gloria A Johnson
- Clinical Social Worker
- Covington, TN
National Provider Identifier
1134567407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4175
- Practice address
- 1997 Highway 51 S
Covington, TN 38019-3630 - Phone
- (901) 475-3593
- Fax
- (901) 313-1124
- NPI assigned
- Jun 10, 2013
- 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 | 4175 | TN | Primary |
Addresses
Primary practice location
1997 Highway 51 S
Covington, TN 38019-3630
Mailing address
1997 Highway 51 S
Covington, TN 38019-3630
Phone (901) 475-3593
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4175 | Other | TN | LCSW |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4175 | TN | MD | Physical Rehabilitation Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1134567407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1997 HIGHWAY 51 S",
"city": "COVINGTON",
"state": "TN",
"postal_code": "380193630",
"telephone_number": "901-475-3593",
"fax_number": "901-313-1124"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1997 HIGHWAY 51 S",
"city": "COVINGTON",
"state": "TN",
"postal_code": "380193630",
"telephone_number": "901-475-3593",
"fax_number": "901-313-1124"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "GLORIA",
"middle_name": "A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-10",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "4175",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "4175",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Covington, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.