Cody William Redd Johnson, LPC, NCC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

LCPC-10144 Issued in ID

Practice address

156 McClure Ave
Nampa, ID 83651-2025

Phone

(208) 323-9600

Fax

(208) 466-5359

NPI assigned

Mar 9, 2018

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Nampa, ID
  • NPI 1457309122
  Medicare reassignment NPD
• Community Health Clinics, Inc.

  dba Terry Reilly - Vista

  • Federally Qualified Health Center (FQHC)
  • Boise, ID
  • NPI 1346254026

  Counselor

  NPD
• Community Health Clinics, Inc.

  dba Terry Reilly Health Services

  • Federally Qualified Health Center (FQHC)
  • Caldwell, ID
  • NPI 1831574276
  NPD

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1457854044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836530009",
            "telephone_number": "208-467-4431",
            "fax_number": "208-467-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 MCCLURE AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836512025",
            "telephone_number": "208-323-9600",
            "fax_number": "208-466-5359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDD JOHNSON",
        "first_name": "CODY",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "LPC, NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-09",
        "last_updated": "2024-03-15",
        "certification_date": "2024-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "ID",
            "license": "LCPC-10144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LPC-6773",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Razer
• Penny Rea, NP-C
• Kade Ready, PA-C
• Rebecca Holmstead, LLC (Nampa Midwifery)
• Rebekah Scott, LLC
• Phillip James Redd, DO
• Reddish Pharmacy Inc (Reddish Pharmacy)
• Kevin Edward Reddish
• Anthony Bruce Reece, FNP-C
• Brenda Lee Reed, M.S., CCCSLP

• Counselor in Nampa, ID
• Providers in Nampa, ID by specialty
• Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.