Active NPI
Dan Johnson PHD Clinical Neuropsychologist,P.a.
- Specialist
- Jonesboro, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 01-10P
- Legal business name
- DAN JOHNSON PHD CLINICAL NEUROPSYCHOLOGIST,P.A.
- Practice address
- 1201 Fleming Ave
Jonesboro, AR 72401-4311 - Phone
- (870) 933-5174
- Fax
- (870) 933-5235
- NPI assigned
- Feb 2, 2007
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dan Johnson, PHD
- Title
- Ceo
- Phone
- (870) 933-5174
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 01-10P | AR | Primary |
Addresses
Primary practice location
1201 Fleming Ave
Jonesboro, AR 72401-4311
Mailing address
1201 Fleming Ave
Jonesboro, AR 72401-4311
Phone (870) 933-5174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Clinical Neuropsych PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Jonesboro, AR
- NPI 1740579069
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Clinical Neuropsychologist
- Jonesboro, AR
- NPI 1720004716
-
- Family Medicine Physician
- Jonesboro, AR
- NPI 1093778169
-
- Family Medicine Physician
- Jonesboro, AR
- NPI 1811001282
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170374400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1174661003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 FLEMING AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014311",
"telephone_number": "870-933-5174",
"fax_number": "870-933-5235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 FLEMING AVE",
"city": "JONESBORO",
"state": "AR",
"postal_code": "724014311",
"telephone_number": "870-933-5174",
"fax_number": "870-933-5235"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAN JOHNSON PHD CLINICAL NEUROPSYCHOLOGIST,P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "DAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "870-933-5174",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AR",
"license": "01-10P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jonesboro, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.