Carly Johnson, AU.D.

Primary specialty

AudiologistTaxonomy code 231H00000X

License

000672 Issued in CT

Practice address

46 Prince St Ste 601
New Haven, CT 06519-1634

Phone

(203) 752-1726

Fax

(855) 451-0554

NPI assigned

Sep 11, 2017

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 identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FEBFCA

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.

• Ear Nose & Throat Medical and Surgical Group, LLC

  • Nurse Practitioner
  • New Haven, CT
  • NPI 1679835086
  NPD (past)

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1285153395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 BROADWAY FL 2",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732363",
            "telephone_number": "203-234-1324",
            "fax_number": "855-476-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 PRINCE ST STE 601",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191634",
            "telephone_number": "203-752-1726",
            "fax_number": "855-451-0554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31 Broadway Fl 2",
            "address_purpose": "LOCATION",
            "city": "North Haven",
            "state": "CT",
            "postal_code": "064732363",
            "country_code": "US",
            "telephone_number": "203-234-1324",
            "fax_number": "855-476-0993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "954 Main St Ste Broadway",
            "address_purpose": "LOCATION",
            "city": "Branford",
            "state": "CT",
            "postal_code": "064057727",
            "country_code": "US",
            "telephone_number": "203-481-0003",
            "fax_number": "855-357-1519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2021-10-27",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CT",
            "license": "000672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CT LICENSE",
            "identifier": "000672",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "15400058",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Johnson, MD
• Ann Johnson, PHD
• Bradley Johnson II, APRN
• Brian C Johnson, LMSW
• Cailey Brianna Johnson
• Christa Marie Johnson, AU.D.
• Clinesha Danielle Johnson, M.ED
• Corinne Johnson
• Daniel Yee Johnson
• Darleen D Johnson, APRN

• Audiologist in New Haven, CT
• Providers in New Haven, CT by specialty
• Audiologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; 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.