Mary Carol Johnson, QMHA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1840 Union Ave
North Bend, OR 97459-3422

Phone

(541) 756-2057

Fax

(541) 751-7905

NPI assigned

Jul 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Mary Carol Little Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223337600000",
    "number": "1265697197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 UNION AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593422",
            "telephone_number": "541-756-2057",
            "fax_number": "541-751-7905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 UNION AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593422",
            "telephone_number": "541-756-2057",
            "fax_number": "541-751-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "CAROL",
        "name_prefix": "Mrs.",
        "credential": "QMHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-21",
        "last_updated": "2008-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "LITTLE",
            "middle_name": "CAROL",
            "prefix": "MISS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stormy M Iverson
• Robert Alan James
• Hyun Soo Jang, MD
• Aurora Johnson
• Craig Austin Johnson, DDS
• Joan Jones
• Lonny Jones
• Jennifer Dawn Jordan
• Trisha A Jordan, MA, CRC
• Kimberly Kanies

• Case Manager/Care Coordinator in North Bend, OR
• Providers in North Bend, OR by specialty
• Case Manager/Care Coordinator in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.