Amanda Reane Johnson, MD

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1063923340 Issued in AZ

Practice address

544 S 96TH PL
Mesa, AZ 85208-2512

Phone

(480) 696-0338

NPI assigned

Mar 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Teen Out Reach Services

  • Psychologist
  • Mesa, AZ
  • NPI 1982289062
  NPD Authorized official

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1184209298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "544 S 96TH PL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082512",
            "telephone_number": "623-272-5449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "544 S 96TH PL",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082512",
            "telephone_number": "480-696-0338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 N Wyandotte St",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641161518",
            "country_code": "US",
            "telephone_number": "480-696-0338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "401 E High St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229025119",
            "country_code": "US",
            "telephone_number": "480-696-0338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "546 S Country Club Dr Apt 2080",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852104101",
            "country_code": "US",
            "telephone_number": "480-696-0338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Ashburton Pl",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021081518",
            "country_code": "US",
            "telephone_number": "480-696-0338",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "AMANDA",
        "middle_name": "REANE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "DC",
            "license": "1063923340",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "AZ",
            "license": "1063923340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003008277",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL ANALYSIS",
            "identifier": "1063923340",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103K00000X",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amanda@ourtors.org",
            "affiliation": "Y",
            "endpointDescription": "email address",
            "affiliationName": "Banner Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "544 S 96th Pl",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852082512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "AMANDA@OURTORs.org",
            "affiliation": "Y",
            "endpointDescription": "Exchange",
            "affiliationName": "Teen Out reach Services",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "544 S 96th Pl",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852082512",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ourtors.org",
            "affiliation": "Y",
            "endpointDescription": "Website",
            "affiliationName": "PMP Associates, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "544 S 96th Pl",
            "city": "Mesa",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852082512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bryson Johns
• Rebecca Ann Johns, FNP-C
• Robert F Johns, DO
• Trenton Johns, PHARM.D
• Albert Andrew Johnson, ATC
• Andrew Johnson
• Brayden Daniel Johnson
• Brittany Johnson
• Carl M Johnson, TRPC, CPSS, BHT
• Carlie Lynn Johnson

• Behavior Analyst in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Behavior Analyst in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.