NPIMap

Organization Active NPI

DRS. Johnston & Lawrence

  • Pediatric Dentistry
  • Russellville, AR
National Provider Identifier
1265825004
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3422 Issued in AR
Legal business name
DRS. JOHNSTON & LAWRENCE
Practice address
1610 W C PL
Russellville, AR 72801-2705
Phone
(479) 968-8338
Fax
(479) 968-1688
NPI assigned
Mar 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Mrs. Terri Lynn Johnston
Title
Office Manager
Phone
(479) 968-8338

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 3422 AR Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 2643 AR

Addresses

Primary practice location

1610 W C PL
Russellville, AR 72801-2705

Mailing address

1610 W C PL
Russellville, AR 72801-2705
Phone (479) 968-8338

Other identifiers 4

IdentifierTypeStateIssuer
112087608MedicaidAR
150768608MedicaidAR
5X544OtherARARKANSAS BLUE CROSS BLUE SHIELD
56547OtherARARKANSAS BLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory
Tax ID family
DRS Johnston Lawrence2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1265825004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 W C PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012705",
            "telephone_number": "479-968-8338",
            "fax_number": "479-968-1688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 W C PL",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012705",
            "telephone_number": "479-968-8338",
            "fax_number": "479-968-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. JOHNSTON & LAWRENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSTON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "479-968-8338",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "3422",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AR",
            "license": "2643",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112087608",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150768608",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUE CROSS BLUE SHIELD",
            "identifier": "5X544",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARKANSAS BLUE CROSS BLUE SHIELD",
            "identifier": "56547",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Russellville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.