Individual provider Active NPI

Ashley Myriah Johnson, D.O.

  • Psychiatry Physician
  • Fort Worth, TX
National Provider Identifier
1265546618
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
M1280 Issued in TX
Practice address
6913 Camp Bowie Blvd Ste 171
Fort Worth, TX 76116-7165
Phone
(817) 433-5000
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X M1280 TX Primary

Addresses

Primary practice location

6913 Camp Bowie Blvd Ste 171
Fort Worth, TX 76116-7165

Mailing address

PO Box 12447
Fort Worth, TX 76110-8447

Other identifiers 1

IdentifierTypeStateIssuer
188423101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070508000142 TX Practitioner - PsychiatryPractitioner - Osteopathic Manipulative MedicinePractitioner - Neurology 0648376681 Reassigns benefits to 1 organization
Practice locations: Fort Worth, TX

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Neurology
Education
University of North Texas HSC, College of Osteopathic Med, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

5408 Colleyville Blvd
Colleyville, TX 76034-5833
Phone (817) 498-9920

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Nov 11, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 11, 2019 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Department of State Health Services Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

Interoperability endpoints

  • Direct secure messaging: ajohnson562806@direct.sw.org

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1265546618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12447",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761108447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6913 CAMP BOWIE BLVD STE 171",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167165",
            "telephone_number": "817-433-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ASHLEY",
        "middle_name": "MYRIAH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "M1280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188423101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.