Individual provider Active NPI

Trecia Sue Johnson, DC

  • Chiropractor
  • Columbus, MS
National Provider Identifier
1154407989
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
961 Issued in MS
Practice address
613 18TH Ave No
Columbus, MS 39701
Phone
(662) 327-8232
Fax
(662) 328-6794
NPI assigned
Oct 27, 2006
Last updated
Jan 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 961 MS Primary
Chiropractor 111N00000X 390 AK

Addresses

Primary practice location

613 18TH Ave No
Columbus, MS 39701

Mailing address

613 18TH Ave No
Columbus, MS 39701
Phone (662) 327-8232

Other identifiers 1

IdentifierTypeStateIssuer
C02511OtherMC GROUP ID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080516000433 MS Practitioner - Chiropractic 4082792437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

613 18TH N Ave
Columbus, MS 39701-2237
Phone (662) 327-8232

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
961MSMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Health Center., PLLC Chiropractor CurrentSince Jan 2, 2008 Accepting new patients

Locations

613 18th Ave N
Columbus, MS 39701
Phone (662) 327-8232

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1154407989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "613 18TH AVE NO",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-327-8232",
            "fax_number": "662-328-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 18TH AVE NO",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-327-8232",
            "fax_number": "662-328-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TRECIA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "961",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "390",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC GROUP ID",
            "identifier": "C02511",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.