Individual provider Active NPI

Paula Hancock Johnson, LCSW

  • Social Worker
  • Jefferson City, MO
National Provider Identifier
1306077250
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
2008033984 Issued in MO
Practice address
1303 Edgewood Dr Ste 5
Jefferson City, MO 65109
Phone
(573) 690-7803
Fax
(573) 638-2693
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 2008033984 MO Primary

Addresses

Primary practice location

1303 Edgewood Dr Ste 5
Jefferson City, MO 65109

Mailing address

1800 Community
Clinton, MO 64735-8804
Phone (660) 885-8131

Other practice location 1

227 Metro Dr
Jefferson City, MO 65109-1134
Phone (888) 403-1071

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

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532476800000",
    "number": "1306077250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 COMMUNITY",
            "city": "CLINTON",
            "state": "MO",
            "postal_code": "647358804",
            "telephone_number": "660-885-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 EDGEWOOD DR STE 5",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "65109",
            "telephone_number": "573-690-7803",
            "fax_number": "573-638-2693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "227 Metro Dr",
            "address_purpose": "LOCATION",
            "city": "Jefferson City",
            "state": "MO",
            "postal_code": "651091134",
            "country_code": "US",
            "telephone_number": "888-403-1071",
            "fax_number": "573-634-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAULA",
        "middle_name": "HANCOCK",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2018-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2008033984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.