Individual provider Active NPI

Adam Johnson, LSCSW, LMAC

  • Clinical Social Worker
  • Manhattan, KS
National Provider Identifier
1144456146
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
4234 Issued in KS
Practice address
1558 Hayes Dr
Manhattan, KS 66502-5068
Phone
(785) 587-4315
Fax
(785) 587-4339
NPI assigned
Jun 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 008 KS
Addiction (Substance Use Disorder) Counselor 101YA0400X 616 KS
Social Worker 104100000X 7407 KS
Clinical Social Worker 1041C0700X 4234 KS Primary

Addresses

Primary practice location

1558 Hayes Dr
Manhattan, KS 66502-5068

Mailing address

PO Box 747
Manhattan, KS 66505-0747
Phone (785) 587-4300

Other identifiers 2

IdentifierTypeStateIssuer
200609070AMedicaidKS
11974774OtherCAQH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20130719000715 KS Practitioner - Clinical Social Worker 8123269925 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andrews and Associates IncGroup PAC ID 2769574748, 5 clinicians

Practice addresses (Care Compare)

4201 Anderson Ave
Suite D110
Manhattan, KS 66503-7603
Phone (785) 539-5455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008KSMDAddiction (Substance Use Disorder) Counselor
7407KSMDSocial Worker
4234KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pawnee Mental Health Service, Inc. CurrentSince Jan 17, 2018 Accepting new patients
Pawnee Mental Health Service, Inc. CurrentSince Jan 17, 2018 Accepting new patients

Locations

814 Caroline Ave
Junction City, KS 66441
Phone (785) 762-5250

1558 Hayes Dr
Manhattan, KS 66502
Phone (785) 587-4315

2001 Claflin Rd
Manhattan, KS 66502

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": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549411200000",
    "number": "1144456146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 747",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665050747",
            "telephone_number": "785-587-4300",
            "fax_number": "785-587-4377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1558 HAYES DR",
            "city": "MANHATTAN",
            "state": "KS",
            "postal_code": "665025068",
            "telephone_number": "785-587-4315",
            "fax_number": "785-587-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ADAM",
        "credential": "LSCSW, LMAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2019-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "008",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "616",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "KS",
            "license": "7407",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "4234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200609070A",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11974774",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhattan, KS

Sources for this page

Verify at the official NPI Registry.