Robert Eric Johnson, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY61114622 Issued in WA

Practice address

3150 Horton Rd
Forest Hill, TX 76119-5905

Phone

(817) 413-3274

NPI assigned

Aug 5, 2007

Last updated

May 28, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Daniel Kim Professional name

Medicare fee-for-service enrollment

Enrolled in WA, TX2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

U S Health Dept of Health and Human ServicesGroup PAC ID 9638081623, 98 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• US Health Dept of Health & Human Services

  • Rural Health Clinic/Center
  • Poplar, MT
  • NPI 1972694602

  TX

  Medicare reassignment Care Compare group
• Puget Sound Senior Psychology LLC

  dba Senior Connections

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1487881488
  Medicare reassignment
• Federal Correctional Institution

  • Community/Behavioral Health Agency
  • Forest Hill, TX
  • NPI 1275733446
  NPD (past)

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622160000000",
    "number": "1306037445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 HORTON RD",
            "city": "FOREST HILL",
            "state": "TX",
            "postal_code": "761195905",
            "telephone_number": "817-413-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 HORTON RD",
            "city": "FOREST HILL",
            "state": "TX",
            "postal_code": "761195905",
            "telephone_number": "817-413-3274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY61114622",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "1981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "KIM",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Anthony Hoang
• Impressive Hands LLC
• Inspired Divinely Health Care, LLC (none)
• Jehoram Christian Outreach Ministries
• Jeremy Simmons, PLLC (Nova Family Dental)
• Olutoyin Ezekiel Makinde, RPH
• Bryana M Martin, PSY.D.
• Omolara Madinat Medaiyese, PMHNP
• Stephanie Ifeoma Menes, MD
• Ali Moshtaghfard

• Clinical Psychologist in Forest Hill, TX
• Providers in Forest Hill, TX by specialty
• Clinical Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.