Individual provider Active NPI

Donna R. Johnson, PH.D.

  • Clinical Psychologist
  • Colorado Springs, CO
National Provider Identifier
1265567929
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
472 Issued in CO
Practice address
130 E Monument St
Suite 202
Colorado Springs, CO 80903-1019
Phone
(719) 635-9091
Fax
(719) 634-3320
NPI assigned
Feb 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 472 CO Primary

Addresses

Primary practice location

130 E Monument St
Suite 202
Colorado Springs, CO 80903-1019

Mailing address

130 E Monument St
Suite 202
Colorado Springs, CO 80903-1019
Phone (719) 635-9091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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

Enrollment IDStateProvider typePAC IDDetails
I20120305000384 CO Practitioner - Clinical Psychologist 8921161472 Practice locations: Colorado Springs, CO

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

525 N Nevada Ave
Suite 105
Colorado Springs, CO 80903-1156
Phone (719) 635-9091

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
472COMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Frank C Szvetecz MD PC Past Accepting new patients
Peak Vista Community Health Centers PastSince Dec 18, 2008 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1265567929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E MONUMENT ST",
            "address_2": "SUITE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031019",
            "telephone_number": "719-635-9091",
            "fax_number": "719-634-3320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E MONUMENT ST",
            "address_2": "SUITE 202",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031019",
            "telephone_number": "719-635-9091",
            "fax_number": "719-634-3320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DONNA",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.