Organization Active NPI

Phoenix Mental Health TMS PLLC

  • Psychiatry Physician
  • San Antonio, TX
National Provider Identifier
1215557152
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
PHOENIX MENTAL HEALTH TMS PLLC
Practice address
23119 W Interstate 10 BLDG 7
San Antonio, TX 78257-1767
Phone
(210) 994-6336
Fax
(210) 994-6441
NPI assigned
Apr 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Authorized official

Name
Dr. Nathan Johnston, DO, MSNPI 1619232113
Title
Owner
Phone
(210) 994-6336

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

23119 W Interstate 10 BLDG 7
San Antonio, TX 78257-1767

Mailing address

23119 W Interstate 10 BLDG 7
San Antonio, TX 78257-1767
Phone (210) 994-6336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200512000685 TX Part B Supplier - Clinic/Group Practice 8921439738 Receives reassigned benefits from 3 practitioners
Practice locations: San Antonio, TX
O20250210002531 WA Part B Supplier - Clinic/Group Practice 8921439738 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

5282 Medical Dr
Ste 602
San Antonio, TX 78229
Phone (210) 994-6336

23103 W Interstate 10
Ste 107
San Antonio, TX 78257

509 Olive Way
Ste 1138
Seattle, WA 98101
Phone (206) 682-0757

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684713600000",
    "number": "1215557152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23119 W INTERSTATE 10 BLDG 7",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571767",
            "telephone_number": "210-994-6336",
            "fax_number": "210-994-6441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23119 W INTERSTATE 10 BLDG 7",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782571767",
            "telephone_number": "210-994-6336",
            "fax_number": "210-994-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX MENTAL HEALTH TMS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-21",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-994-6336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, MS"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.

Verify at the official NPI Registry.