Individual provider Active NPI

Marcus Johnson, BA

  • Social Worker
  • Las Vegas, NV
National Provider Identifier
1396040606
Registry record updated Oct 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455
Phone
(702) 385-5331
Fax
(702) 385-5678
NPI assigned
Jan 18, 2011
Last updated
Oct 6, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary
Rehabilitation Practitioner 225400000X NU
Case Manager/Care Coordinator 171M00000X NU

Addresses

Primary practice location

4285 N Rancho Dr Ste 130
Las Vegas, NV 89130-3455

Mailing address

10100 Elida Rd
Delphos, OH 45833-9056
Phone (702) 646-5437

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
Bachelor of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Specialized Alternatives for Families and Youth of Nevada, Inc. CurrentSince Aug 28, 2022 Accepting new patients
Specialized Alternatives for Families and Youth of Nevada, Inc. Case Manager/Care Coordinator CurrentSince Aug 28, 2022 Accepting new patients
Eagle Quest of Nevada Past Accepting new patients

Locations

4285 N Rancho Dr
Ste 130
Las Vegas, NV 89130

10100 Elida Rd
Delphos, OH 45833
Phone (419) 685-8010

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1295308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791244800000",
    "number": "1396040606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 ELIDA RD",
            "city": "DELPHOS",
            "state": "OH",
            "postal_code": "458339056",
            "telephone_number": "702-646-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4285 N RANCHO DR STE 130",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891303455",
            "telephone_number": "702-385-5331",
            "fax_number": "702-385-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARCUS",
        "credential": "BA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-18",
        "last_updated": "2026-10-06",
        "certification_date": "2026-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2026; 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.