Organization Active NPI

Debora Storey Johnson, MD PC

  • Child & Adolescent Psychiatry Physician
  • Atlanta, GA
National Provider Identifier
1316112188
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
043071 Issued in GA
Legal business name
DEBORA STOREY JOHNSON, MD PC
Practice address
950 Dannon VW SW
Suite 4101
Atlanta, GA 30331-2160
Phone
(404) 699-9600
Fax
(404) 696-7100
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Debora Storey Johnson, M.D.
Title
President and Ceo
Phone
(404) 699-9600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0800X 043071 GA
Child & Adolescent Psychiatry PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2084P0804X 043071 GA Primary

Addresses

Primary practice location

950 Dannon VW SW
Suite 4101
Atlanta, GA 30331-2160

Mailing address

950 Dannon VW SW
Suite 4101
Atlanta, GA 30331-2160
Phone (404) 699-9600

Other identifiers 1

IdentifierTypeStateIssuer
070979307AMedicaidGA

Other names 1

  • Cascade Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

950 Dannon Vw SW
Ste 4101
Atlanta, GA 30331
Phone (404) 963-1097

NPI Registry JSON

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1316112188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 DANNON VW SW",
            "address_2": "SUITE 4101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312160",
            "telephone_number": "404-699-9600",
            "fax_number": "404-696-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 DANNON VW SW",
            "address_2": "SUITE 4101",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312160",
            "telephone_number": "404-699-9600",
            "fax_number": "404-696-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORA STOREY JOHNSON, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DEBORA",
        "authorized_official_middle_name": "STOREY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "404-699-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "043071",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "GA",
            "license": "043071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070979307A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.