Active NPI
Kathleen R Johnson, M.D.
- Psychiatry Physician
- New York, NY
National Provider Identifier
1346586005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 138756-1
- Practice address
- 420 W End Ave
New York, NY 10024-5708 - Phone
- (908) 892-5402
- NPI assigned
- Dec 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 138756-1 | NY | Primary |
Addresses
Primary practice location
420 W End Ave
New York, NY 10024-5708
Mailing address
152 Aster CT
Whitehouse Station, NJ 08889-2031
Phone (908) 823-4271
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 138756-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356566400000",
"number": "1346586005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "152 ASTER CT",
"city": "WHITEHOUSE STATION",
"state": "NJ",
"postal_code": "088892031",
"telephone_number": "908-823-4271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 W END AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100245708",
"telephone_number": "908-892-5402"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KATHLEEN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-27",
"last_updated": "2012-12-27",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NY",
"license": "138756-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.