Brian Burke Johnson, PLMHP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY004540 Issued in GA

Practice address

13460 Walsh Dr
Boys Town, NE 68010-7529

Phone

(531) 355-3358

Fax

(531) 355-3375

NPI assigned

May 28, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Clinical Psychologist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Blue Ridge Psychological Services, LLCGroup PAC ID 1759428063, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Blue Ridge Psychological Services, LLC

  • Clinical Psychologist
  • Blue Ridge, GA
  • NPI 1750524781
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1559001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1235796004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2313 N WEBB RD",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688031743",
            "telephone_number": "308-381-8851",
            "fax_number": "308-381-8853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "531-355-3358",
            "fax_number": "531-355-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIAN",
        "middle_name": "BURKE",
        "credential": "PLMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-28",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "11864",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY004540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Inbarasu, M.D.
• Sara Lynn Irwin, LMHP, PLADC
• Natalie Marie Jensen, PHD, LP
• Mark Layne Jenson, M.D.
• Ann Catherine Johnson, PLMHP
• Oliver George Johnston, MS
• Caitlin Jordan, DNP APRN CPNP- AC/PC
• Monica Maria Kelly, M.D.
• Melissa Kerr, APRN
• Steven M Koch, PHD, LP

• Psychologist in Boys Town, NE
• Providers in Boys Town, NE by specialty
• Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.