Individual provider Active NPI

Darryl E Johnson, M.A., F.A,A.A.

  • Audiologist
  • Glendale, AZ
National Provider Identifier
1265589725
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA1308 Issued in AZ
Practice address
13934 N 59TH Ave
Suite 120
Glendale, AZ 85306-4167
Phone
(602) 866-0147
Fax
(602) 547-9644
NPI assigned
Jan 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA1308 AZ Primary

Addresses

Primary practice location

13934 N 59TH Ave
Suite 120
Glendale, AZ 85306-4167

Mailing address

13934 North 59TH Ave
Suite 120
Glendale, AZ 85308-4168
Phone (602) 866-0147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
DA1308AZMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265589725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13934 NORTH 59TH AVE",
            "address_2": "SUITE 120",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853084168",
            "telephone_number": "602-866-0147",
            "fax_number": "602-547-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13934 N 59TH AVE",
            "address_2": "SUITE 120",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853064167",
            "telephone_number": "602-866-0147",
            "fax_number": "602-547-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DARRYL",
        "middle_name": "E",
        "name_prefix": "Mr.",
        "credential": "M.A., F.A,A.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA1308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.